| Dietrich Pc | |
|
300 N State St, Harrisville, MI 48740-9693 | |
| (989) 724-7440 | |
| (989) 724-7531 |
| Full Name | Dietrich Pc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 300 N State St, Harrisville, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497173322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152WV0400X | Optometrist - Vision Therapy | 4901004764 (Michigan) | Secondary |
| 152W00000X | Optometrist | 4901004764 (Michigan) | Primary |
| Provider Name | Benjamin David Dietrich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073952297 PECOS PAC ID: 1850534439 Enrollment ID: I20130829000521 |
| Mailing Address | Practice Location Address |
|---|---|
| Dietrich Pc 300 N State St, Harrisville, MI 48740-9693 Ph: (989) 724-7440 | Dietrich Pc 300 N State St, Harrisville, MI 48740-9693 Ph: (989) 724-7440 |
Pasqua Darnell Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 300 North Us-23, Harrisville, MI 48740 Phone: 989-724-7440 Fax: 989-724-7531 | |
Dr. Benjamin David Dietrich, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 300 N State St, Harrisville, MI 48740 Phone: 989-724-7440 Fax: 989-724-7531 |