Individual
JONATHAN R. DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
6015 W PEORIA AVE, GLENDALE, AZ 85302-1213
(440) 062-3344
Mailing address
7002 W MAYBERRY TRL, PEORIA, AZ 85383-3168
(605) 376-6941
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
019298
AZ
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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