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1265917827
AUSTIN DEAN DIEDERICH
MANHATTAN, KS
NPI
1265917827
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-09-30
Last Update Date
2018-09-30
Business Address
AUSTIN DEAN DIEDERICH
915 CLAFLIN RD
MANHATTAN, KS 66502-4610
Phone number: 785-747-8186
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Mailing Address
AUSTIN DEAN DIEDERICH
2026 4TH RD
GREENLEAF, KS 66943-9410
Phone number: 785-747-8186
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