Individual
COREY LYNN DIETZE
Active
Individual
COREY LYNN DIETZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC-LAC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
04029
IA
225100000X
Physical Therapist
Primary
11466
TN
225100000X
Physical Therapist
2305207917
VA
225100000X
Physical Therapist
29738
FL
225100000X
Physical Therapist
9739
CO
2251X0800X
Orthopedic Physical Therapist
11466
UT
2255A2300X
Athletic Trainer
00515
IA
2255A2300X
Athletic Trainer
4253
FL
Other
Enumeration date
03/21/2007
Last updated
02/10/2020
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