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Individual

MR. JESSE LEE DIMICK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PTA, LATC

Contact information

Practice address
43 REDLANDS RD, WEST ROXBURY, MA 02132-1506
(617) 892-2749
Mailing address
43 REDLANDS RD, WEST ROXBURY, MA 02132-1506
(617) 892-2749

Taxonomy

Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
1708
MA

Other

Enumeration date
06/22/2006
Last updated
07/08/2007
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