Healthcare Provider Details

I. General information

NPI: 1235238312
Provider Name (Legal Business Name): JAMES MATHEW DILLMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 EAST MARKLAND AVE
KOKOMO IN
46901-6663
US

IV. Provider business mailing address

2616 EAST MARKLAND AVE
KOKOMO IN
46901-6663
US

V. Phone/Fax

Practice location:
  • Phone: 765-459-8551
  • Fax: 765-459-3321
Mailing address:
  • Phone: 765-459-8551
  • Fax: 765-459-3321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08001040A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: