Most Relevant Information
Provider Data
| NPI Number: | 1003253352 |
| Provider Name: | RYAN RICHARD DIETLEIN D.P.T |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 5501016312 |
Most Important Dates
| Enumeration Date: | 05/28/2013 |
| Last Updated: | 05/28/2013 |
Provider Practice Location
203 DILTS RD
ITHACA
MI
488479475
Practice Location Phone/Fax
| Phone: | 9898752266 |
| Fax: | 9898752225 |
Provider Mailing Location
203 DILTS RD
ITHACA
MI
488479475
Provider Mailing Phone/Fax
| Phone: | 9898752266 |
| Fax: | 9898752225 |