Individual
DAVID J DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4802 E BROADWAY, MADISON, WI 53716-4141
(608) 889-7500
Mailing address
8444 N 90TH ST STE 100, SCOTTSDALE, AZ 85258-4437
(602) 248-8886
(602) 854-0504
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
130796
WY
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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