Jonathan Grant Dicke
Jonathan Grant Dicke is a Student in an Organized Health Care Education/Training Program in Albuquerque, New Mexico. Licensed in New Mexico. Registered with an NPI since 2024.
- Licensed in
- NM
- In the registry since
- 2024
Practice location Address checks out
MSC10 5600 1 University Of New MexicoAlbuquerque, NM 87131-0001
Phone: (505) 272-2231
Fax: (505) 272-8098
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X · Licence RS2024-0060 (NM) |
|---|
Record details
| NPI number | 1013761147 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 15, 2024 |
| Last updated in NPPES | January 3, 2025 |
| Certification date | January 3, 2025 |
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