Provider Demographics
NPI:1679681779
Name:DILLON, MICHELLE (RT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50444
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-0444
Mailing Address - Country:US
Mailing Address - Phone:406-839-1063
Mailing Address - Fax:
Practice Address - Street 1:2800 CENTRAL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4666
Practice Address - Country:US
Practice Address - Phone:406-839-1063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT240521247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
28094OtherARDMS
240521OtherARRT