Provider Demographics
NPI:1063956837
Name:KAPP, DILLON SCOTT (MS, ATC)
Entity type:Individual
Prefix:
First Name:DILLON
Middle Name:SCOTT
Last Name:KAPP
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4448 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1030
Mailing Address - Country:US
Mailing Address - Phone:412-877-1532
Mailing Address - Fax:
Practice Address - Street 1:4448 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1030
Practice Address - Country:US
Practice Address - Phone:412-877-1532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA20000219672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer