Organization
DIETRICH CHIROPRACTIC, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B. DIETIRCH II DC (PRESIDENT)
(715) 423-4050
Entity
Organization
Contact information
Practice address
1105 W GRAND AVE, WISCONSIN RAPIDS, WI 54495-3349
(715) 423-4050
(715) 424-3108
Mailing address
1105 W GRAND AVE, WISCONSIN RAPIDS, WI 54495-3349
(715) 423-4050
(715) 424-3108
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3621-012
WI
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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