Charles M Dietrich, DC

NPI #1104985019 in Keyport, New Jersey

Provider Information

NPI Number: 1104985019
Entity Type: Individual
Name: Charles M Dietrich, DC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chiropractor
Credential: DC
Enumeration Date: Dec 6, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 250 MAPLE PLACE
City: Keyport
State: New Jersey
ZIP Code: 07735-1144
Phone: (732) 264-8900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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