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Individual

DAVID DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
124 WINDSOR PARK DR, CAROL STREAM, IL 60188-1986
(630) 510-4700
Mailing address
818 INDIANA AVE, ST CHARLES, IL 60174-3138
(773) 716-4725

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.008407
IL

Other

Enumeration date
02/06/2014
Last updated
02/06/2014
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