Organization
DIETRICH OPTICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER ALLEN GOETZ OPTICIAN (OWNER)
(732) 223-2020
Entity
Organization
Contact information
Practice address
134 MAIN ST, MANASQUAN, NJ 08736-3558
(732) 223-2020
Mailing address
134 MAIN ST, MANASQUAN, NJ 08736-3558
(732) 223-2020
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
31TD00185200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7425406
—
NJ
Enumeration date
12/26/2007
Last updated
12/26/2007
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