JASON PAUL DIETERLE DO
Individual Provider (NPI-1)
Active
Orthopaedic Surgery, Sports Medicine
Provider Information
- NPI Number
1376730069- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DO
- Status
- Active
Contact & Location
- Address
- 5715 MEMORIAL AVE N, OAK PARK HEIGHTS, MN, 550821093
- Phone
- (651) 439-8807
- Fax
- (651) 439-0232
Specialties & Taxonomies
Orthopaedic Surgery
License: MN #51694
Orthopaedic Surgery
License: WI #52724-21
Orthopaedic Surgery, Sports Medicine
License: WI #52724-21
Orthopaedic Surgery, Sports Medicine
Primary License: MN #51694