Individual
DERRITT JAMES DIETLMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19333 W NORTH AVE, BROOKFIELD, WI 53045-4132
(262) 785-2060
Mailing address
226 CIRCLE DR, HARTLAND, WI 53029-1807
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
255187-30
WI
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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