Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. STEVEN TODD DIETZMAN, LAT
ActiveMR. STEVEN TODD DIETZMAN, LAT is a Athletic Trainer healthcare provider located in MEDFORD, Wisconsin. NPI 1851426753 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · MEDFORD, WI
Registration Details
- NPI Number
- 1851426753
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 22, 2007 (19.438425375778 yrs)
- Last Updated
- Jul 10, 2007
- License
-
197-039 (WI)
Practice Information
- Address
-
103 SOUTH GIBSON STREETMEDFORD, WI, 54451Browse WI providers · Browse ZIP 54451
- Phone
- 7157488112
- Fax
- 7157488792
- Primary Specialty
-
Athletic Trainer
2255A2300X
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.