Provider Demographics
NPI:1770207318
Name:DIETZEL, MARCIA A (DACM, LAC)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:A
Last Name:DIETZEL
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 LOUIS PASTEUR DR STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4510
Mailing Address - Country:US
Mailing Address - Phone:210-834-0823
Mailing Address - Fax:
Practice Address - Street 1:7400 LOUIS PASTEUR DR STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4510
Practice Address - Country:US
Practice Address - Phone:210-834-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist