Doctor Name: | JEFF L DIETRICH |
NPI Number: | 1073578548 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 0911 |
Business Practice Address: | 7351 Prairie Falcon Rd 100 Las Vegas, NV - 891280820 |
Business Phone Number: | 7029680520 |
Business Fax Number: | 7029680521 |
Mailing Address: | 7351 Prairie Falcon Rd, 100 LAS VEGAS |
State: | NV |
Postal Code: | 891280820 |
Phone Number: | 7029680520 |
Fax Number: | 7029680521 |
NPI Enumeration Date: | 04/19/2006 |
NPI Last Update Date: | 01/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 0911 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NV |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |