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General NPI Number Information
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NPI Number | 1851783823
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Entity Type | Individual
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Provider Name | HEATHER TUCK DILLOW LPTA
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Gender | Female
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Dates
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Enumeration Date | 02/26/2015
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Last Update Date | 02/26/2015
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Provider Practice Location Address
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Address Line | 9268 HANOVER CROSSING DR APT H
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-3927
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Country | US
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Telephone | 804-316-7806
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Fax |
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Provider Business Mailing Address
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Address Line | 9268 HANOVER CROSSING DR APT H
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City | MECHANICSVILLE
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State | VA
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Zip | 23116-3927
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Country | US
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Telephone | 804-316-7806
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2306603792
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License Number State | VA
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