Individual
DR. JOHN R DIETLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6886 HOLLOW MILL DR, SALT LAKE CITY, UT 84121-3322
(801) 944-0095
Mailing address
PO BOX 712270, SALT LAKE CITY, UT 84171-2270
(801) 944-0095
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
83-169963-1205
UT
Other
Enumeration date
02/27/2006
Last updated
10/19/2007
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