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General NPI Number Information
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NPI Number | 1558722009
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Entity Type | Individual
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Provider Name | DILLON CAMPBELL MS, LAT, ATC, NREMT
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Gender | Male
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 510 W KILBOURN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53203-1313
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Country | US
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Telephone | 615-906-0336
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 KLONDIKE PL
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City | CASTLE ROCK
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State | CO
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Zip | 80108-8311
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Country | US
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Telephone | 720-219-3929
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 3240-39
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License Number State | WI
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