MEDICARE: DR. LORETTA DILLON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1036358	TX

General Provider Information

NPI Number	:	1861651358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORETTA DILLON PT

Provider Business Mailing Address
First Line	:	3303 GABEL AVE
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1007
Country	:	US
Telephone Number	:	915-757-9441
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 N CAMPBELL ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-4238
Country	:	US
Telephone Number	:	915-747-8215
Fax Number	:	915-747-8211

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2008
Last Update Date	:	06/09/2008

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Directions to “ DR. LORETTA DILLON PT” Practice Location

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