Provider Demographics
NPI:1639642226
Name:BALKIN, DILLON D
Entity Type:Individual
Prefix:
First Name:DILLON
Middle Name:D
Last Name:BALKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N WASHINGTON ST STE 207
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2225
Mailing Address - Country:US
Mailing Address - Phone:301-637-9727
Mailing Address - Fax:
Practice Address - Street 1:110 N WASHINGTON ST STE 207
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2225
Practice Address - Country:US
Practice Address - Phone:301-637-9727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor