Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JESSE LEE DIMICK, PTA, LATC
ActiveMR. JESSE LEE DIMICK, PTA, LATC is a Sports Medicine (PM&R) healthcare provider located in WEST ROXBURY, Massachusetts. NPI 1386680809 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · WEST ROXBURY, MA
Registration Details
- NPI Number
- 1386680809
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 22, 2006 (20.185469425532 yrs)
- Last Updated
- Jul 8, 2007
- License
-
1708 (MA)
Practice Information
- Address
-
43 REDLANDS RDWEST ROXBURY, MA, 021321506Browse MA providers · Browse ZIP 02132
- Phone
- 6178922749
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.