MR. Jon Dale Dieckman, ATC
NPI #1376613588 in Madison, Mississippi
Provider Information
- NPI Number
- 1376613588
- Entity Type
- Individual
- Name
- MR. Jon Dale Dieckman, ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Nov 8, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 506 LINCOLN CV
- City
- Madison
- State
- Mississippi
- ZIP Code
- 39110-7337
- Phone
- (601) 853-7765
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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