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Individual

MR. CHRISTOPHER DAVID DIETRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
9860 E TERN DR, PALMER, AK 99645-9103
(509) 551-1174
Mailing address
16600 CENTERFIELD DR STE 205, EAGLE RIVER, AK 99577-7702
(907) 696-7466

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2393
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1626073
AK
Enumeration date
12/29/2014
Last updated
02/19/2025
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