Individual
DR. CORY LYNN DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 W US HIGHWAY 24, WOODLAND PARK, CO 80863-8975
(719) 522-1133
Mailing address
2 S CASCADE AVE STE 140, COLORADO SPRINGS, CO 80903-1604
(719) 538-2900
(719) 538-2907
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28289
IA
207Q00000X
Family Medicine Physician
Primary
DR.0053528
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28530250
—
CO
05
—
3064089
—
IA
Enumeration date
03/17/2006
Last updated
02/19/2024
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