RICHARD GRENVILLE DIEDRICH

FARMINGTON, NM
NPI1255363149
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: NM  NM 80-29)
Enumeration Date2006-07-07
Last Update Date2007-07-08
Business Address
-- RICHARD GRENVILLE DIEDRICH MD
1001 D W. BROADWAY
FARMINGTON, NM 87401
Phone number: 505-327-4796
Mailing Address
-- RICHARD GRENVILLE DIEDRICH MD
116 PINE RIVER RANCH CIR
BAYFIELD, CO 81122-9325
Phone number: 970-884-4831
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