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Contact Information

COREY L DIETZE, DPT, ATC-LAC
BLANCHFIELD ARMY COMMUNITY HOSPITAL
650 JOEL DRIVE
FORT CAMPBELL, KY42223
 Phone: 270-798-8400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Athletic Trainer

2255A2300X
 

Orthopedic

2251X0800X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for COREY L DIETZE · (Male)

NPI Number 1417073875
Status Active
Credentials DPT, ATC-LAC
Entity Individual
Enumeration date 03/21/2007
Last updated 02/10/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 9739
  • FL License # 29738
  • FL License # 4253
  • IA License # 00515
  • IA License # 04029
  • TN License # 11466
  • UT License # 11466
  • VA License # 2305207917
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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