Provider Demographics
NPI:1619047396
Name:DINN, PHILLIP CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:CRAIG
Last Name:DINN
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 1:284 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2031
Mailing Address - Country:US
Mailing Address - Phone:859-647-2834
Mailing Address - Fax:859-647-9185
Practice Address - Street 1:284 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2031
Practice Address - Country:US
Practice Address - Phone:859-647-2834
Practice Address - Fax:859-647-9185
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYK4457111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0788001Medicare ID - Type Unspecified