Healthcare Provider Details

I. General information

NPI: 1891158325
Provider Name (Legal Business Name): BRITTANY DILLARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S GOVERNORS AVE
DOVER DE
19904-6901
US

IV. Provider business mailing address

3 COLE BLVD
MIDDLETOWN DE
19709-1618
US

V. Phone/Fax

Practice location:
  • Phone: 302-730-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberJ20001013
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: