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General NPI Number Information
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NPI Number | 1558550277
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Entity Type | Individual
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Provider Name | CLARICE L DILLON LMT
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Gender | Female
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 35000 KAISER CT SUITE 301
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City | WILLOUGHBY
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State | OH
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Zip | 44094-3382
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Country | US
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Telephone | 440-951-6677
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Fax |
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Provider Business Mailing Address
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Address Line | 5247 HAVERFORD DR
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City | LYNDHURST
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State | OH
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Zip | 44124-2711
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Country | US
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Telephone | 440-461-8509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.008634
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License Number State | OH
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