Provider Demographics
NPI:1457006371
Name:DILLON, KATHRYN MARIE
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MARIE
Last Name:DILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:DILLON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:MARBLE
Mailing Address - State:NC
Mailing Address - Zip Code:28905-0083
Mailing Address - Country:US
Mailing Address - Phone:828-629-1234
Mailing Address - Fax:
Practice Address - Street 1:51 WILSON ST
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:NC
Practice Address - Zip Code:28901-2890
Practice Address - Country:US
Practice Address - Phone:828-629-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies