Provider Demographics
NPI:1588908552
Name:FRANK DITTRICH DO LLC
Entity type:Organization
Organization Name:FRANK DITTRICH DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYISICIAN
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:DITTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:330-923-3502
Mailing Address - Street 1:2104 FRONT STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3259
Mailing Address - Country:US
Mailing Address - Phone:330-923-3502
Mailing Address - Fax:330-923-3507
Practice Address - Street 1:2104 FRONT STREET
Practice Address - Street 2:SUITE B
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3259
Practice Address - Country:US
Practice Address - Phone:330-923-3502
Practice Address - Fax:330-923-3507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34001810207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty