Individual
DOUGLAS K. DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
6860 W 115TH ST STE 150, OVERLAND PARK, KS 66211-2400
(913) 253-0600
Mailing address
4113 SW LAHARVE DR, LEES SUMMIT, MO 64082-4697
(816) 537-5391
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
041334
MO
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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