Provider Demographics
NPI:1003688508
Name:DILLARD, HAROLD (LMT CNMT)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:DILLARD
Suffix:
Gender:M
Credentials:LMT CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3269 THORNWAY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6117
Mailing Address - Country:US
Mailing Address - Phone:916-802-6596
Mailing Address - Fax:
Practice Address - Street 1:3269 THORNWAY DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6117
Practice Address - Country:US
Practice Address - Phone:916-802-6596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-27
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist