Mr. Jesse Lee Dimick
Sports Medicine
43 Redlands Rd
West Roxbury
, Massachusetts 02132-1506
Mr. Jesse Lee Dimick
Sports Medicine
43 Redlands Rd
West Roxbury
, Massachusetts 02132-1506
(617) 892-2749
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About
Features
Specialties
- Sports Medicine
Languages spoken
- English
Location
First Address
- Mr. Jesse Lee Dimick
- 43 Redlands Rd
- West Roxbury, MA
- Zip : 02132-1506
- Phone : (617) 892-2749
Second Address
- Mr. Jesse Lee Dimick
- 43 Redlands Rd
- West Roxbury, MA
- Zip : 02132-1506
- Phone : (617) 892-2749
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081S0010X | Sports Medicine | 1708 | MA |
| Y | 213ES0000X | Sports Medicine | 1708 | MA |
National Provider Identifier
| NPI | 1386680809 |
|---|---|
| Provider Name | Mr. Jesse Lee Dimick |
| First Address | West Roxbury, MA 02132-1506 |
| Second Address | West Roxbury, MA 02132-1506 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/06/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.