Provider Demographics
NPI:1518334606
Name:DILA, DARRELL DEAN (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:DEAN
Last Name:DILA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 SPOTSYLVANIA PKWY STE 106
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9435
Mailing Address - Country:US
Mailing Address - Phone:540-710-0100
Mailing Address - Fax:540-710-5333
Practice Address - Street 1:212 BUTLER RD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405
Practice Address - Country:US
Practice Address - Phone:540-710-5144
Practice Address - Fax:540-710-5333
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305209777225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist