Organization
LISA DIETZ DO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA GRACE DIETZ DO (OWNER)
(248) 992-9975
Entity
Organization
Contact information
Practice address
6507 TOWN CENTER DR, STE A, CLARKSTON, MI 48346-4826
(248) 992-9975
(248) 992-9143
Mailing address
6507 TOWN CENTER DR, STE A, CLARKSTON, MI 48346-4826
(248) 992-9975
(248) 992-9143
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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