Provider Demographics
NPI:1841240025
Name:DILLINGER, CHRISTIAN RICHARD (PT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:RICHARD
Last Name:DILLINGER
Suffix:
Gender:M
Credentials:PT
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 30708
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-3708
Mailing Address - Country:US
Mailing Address - Phone:405-610-7700
Mailing Address - Fax:
Practice Address - Street 1:201 HARROZ LN
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7722
Practice Address - Country:US
Practice Address - Phone:405-830-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2947225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00443158OtherRR MEDICARE