GRANT MICHAEL DIETZ PA-C
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1538943618- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA-C
- Status
- Active
Contact & Location
- Address
- 10115 E 80TH ST STE A, TULSA, OK, 741333421
- Phone
- (918) 994-4400
Specialties & Taxonomies
Physician Assistant
Primary License: OK #5700