Provider Demographics
NPI:1407030703
Name:DILLON CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:DILLON CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:606-929-9667
Mailing Address - Street 1:5936 SWANSON DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-7205
Mailing Address - Country:US
Mailing Address - Phone:606-929-9667
Mailing Address - Fax:
Practice Address - Street 1:5936 SWANSON DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-7205
Practice Address - Country:US
Practice Address - Phone:606-929-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1407030703Medicare NSC
KY7367Medicare PIN