| Organization Name: | DIETRICH PC |
| NPI Number: | 1497173322 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOIS JEAN WESTERGARD (OFFICE MANAGER) |
| Mailing Address: | 300 S State St Harrisville |
| State: | MI US |
| Postal Code: | 487409408 |
| Phone Number: | 9897247440 |
| Fax Number: | 9897247531 |
| NPI Enumeration Date: | 03/28/2014 |
| NPI Last Update Date: | 03/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WV0400X |
| License Number: | 4901004764 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Vision Therapy |
| Taxonomy Definition: | Optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. |