Provider Demographics
NPI:1659127538
Name:DIETZ EYE CARE & ASSOCIATES LLC
Entity type:Organization
Organization Name:DIETZ EYE CARE & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-228-3937
Mailing Address - Street 1:2765 FORT AMANDA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45805-4813
Mailing Address - Country:US
Mailing Address - Phone:419-228-3937
Mailing Address - Fax:419-228-3939
Practice Address - Street 1:2765 FORT AMANDA RD STE 100
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45805-4813
Practice Address - Country:US
Practice Address - Phone:419-228-3937
Practice Address - Fax:419-228-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty