Provider Demographics
NPI:1699170076
Name:FINK, DILLON
Entity type:Individual
Prefix:
First Name:DILLON
Middle Name:
Last Name:FINK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 N 24TH ST
Mailing Address - Street 2:STE 230
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6534
Mailing Address - Country:US
Mailing Address - Phone:480-607-9200
Mailing Address - Fax:480-607-9207
Practice Address - Street 1:3700 N 24TH ST
Practice Address - Street 2:STE 230
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6534
Practice Address - Country:US
Practice Address - Phone:480-607-9200
Practice Address - Fax:480-607-9207
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist