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General NPI Number Information
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NPI Number | 1912250622
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Entity Type | Individual
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Provider Name | KETREA D DILLON DC
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Gender | Female
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 12020 FM 1960 RD W STE 980
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City | HOUSTON
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State | TX
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Zip | 77065-5363
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Country | US
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Telephone | 281-517-0800
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Fax | 281-517-0803
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Provider Business Mailing Address
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Address Line | 11139 HILLSIDE GLEN TRL
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City | HOUSTON
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State | TX
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Zip | 77065-5023
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Country | US
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Telephone | 713-702-8128
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 10993
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License Number State | TX
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