Most Relevant Information
Provider Data
| NPI Number: | 1003485871 |
| Provider Name: | MICHELE LYNN DIETZ |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | PTA0000005109 |
Most Important Dates
| Enumeration Date: | 06/24/2021 |
| Last Updated: | 06/24/2021 |
Provider Practice Location
1804 BRENTWOOD DR
GREENEVILLE
TN
377436617
Practice Location Phone/Fax
| Phone: | 2317300907 |
| Fax: |
Provider Mailing Location
1804 BRENTWOOD DR
GREENEVILLE
TN
377436617
Provider Mailing Phone/Fax
| Phone: | 2317300907 |
| Fax: |