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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL J DIETZE MD (OWNER)
(402) 462-9009
Entity
Organization

Contact information

Practice address
715 N KANSAS AVE, SUITE 300, HASTINGS, NE 68901
(402) 462-9009
(402) 462-8090
Mailing address
715 N KANSAS AVE, SUITE 300, HASTINGS, NE 68901
(402) 462-9009
(402) 462-8090

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
332H00000X
Eyewear Supplier
Primary
NE

Other

Enumeration date
11/06/2006
Last updated
07/21/2022
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