Individual
KATIE M DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
605 N SHETLAND CT, POST FALLS, ID 83854-5447
(208) 215-8140
Mailing address
605 N SHETLAND CT, POST FALLS, ID 83854-5447
(208) 215-8140
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60221323
WA
Other
Enumeration date
03/22/2012
Last updated
03/22/2012
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