Provider Demographics
NPI:1841748696
Name:DILLON, RORY
Entity Type:Individual
Prefix:MR
First Name:RORY
Middle Name:
Last Name:DILLON
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 1:140 1/2 UNION ST
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:24701-3726
Mailing Address - Country:US
Mailing Address - Phone:304-887-9114
Mailing Address - Fax:304-487-6491
Practice Address - Street 1:140 MISTY LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-6462
Practice Address - Country:US
Practice Address - Phone:304-425-2222
Practice Address - Fax:304-487-6491
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1999-0380225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist