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
ZIP Code
39110-7337
Phone
(601) 853-7765

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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