Individual
MR. JEFF DIETRICHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5670 GREENWOOD PLAZA BLVD STE LL110, GREENWOOD VILLAGE, CO 80111-2448
(303) 694-9193
(303) 779-0566
Mailing address
5670 GREENWOOD PLAZA BLVD STE LL110, GREENWOOD VILLAGE, CO 80111-2448
(303) 694-9193
(303) 779-0566
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2480
HI
225100000X
Physical Therapist
Primary
PTL0016101
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
583444
—
HI
Enumeration date
01/18/2007
Last updated
01/28/2022
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