Provider Demographics
NPI:1033261581
Name:DILLSWORTH, JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:DILLSWORTH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:HONEOYE
Mailing Address - State:NY
Mailing Address - Zip Code:14471-0072
Mailing Address - Country:US
Mailing Address - Phone:585-229-4392
Mailing Address - Fax:585-229-5295
Practice Address - Street 1:2 HONEOYE COMMONS
Practice Address - Street 2:
Practice Address - City:HONEOYE
Practice Address - State:NY
Practice Address - Zip Code:14471
Practice Address - Country:US
Practice Address - Phone:585-229-0404
Practice Address - Fax:585-229-5295
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX4411111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26247Medicare UPIN
NY10206BMedicare ID - Type Unspecified