Provider Demographics
NPI:1376019539
Name:JOB, DYLAN THOMAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:THOMAS
Last Name:JOB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 TRENT CIR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-4181
Mailing Address - Country:US
Mailing Address - Phone:406-690-6435
Mailing Address - Fax:
Practice Address - Street 1:2525 KING AVE W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6425
Practice Address - Country:US
Practice Address - Phone:406-690-6435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-54924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist