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DR. JOSHUA ALAN DIETZE DC

>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1467874941

Individual Registrant:
DR. JOSHUA ALAN DIETZE DC
Gender: M
Sole Proprietor

Location and contact information for practice:
31095 BERQUIST DR  PEQUOT LAKES, MN 56472-5647 US
Tel: 218-568-7767  Fax: --

Contact information for business:
PO BOX 281  PEQUOT LAKES, MN 56472-0281 US
Tel: 218-568-7767  Fax: --

Registration Information:
NPI: 1467874941
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N111N00000XChiropractic Providers
Chiropractor
WI4951-12
Y111N00000XChiropractic Providers
Chiropractor
MN6714

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS MN - Page 1



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