Individual
DR. MANDY JO DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
418 E BROADWAY AVE, SUITE 222, BISMARCK, ND 58501-4086
(701) 223-8413
(701) 425-0148
Mailing address
418 E BROADWAY AVE, SUITE 222, BISMARCK, ND 58501-4086
(701) 223-8413
(701) 425-0148
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0911
ND
Other
Enumeration date
07/19/2012
Last updated
07/19/2012
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