Provider Demographics
NPI:1861651358
Name:DILLON, LORETTA (PT)
Entity Type:Individual
Prefix:DR
First Name:LORETTA
Middle Name:
Last Name:DILLON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 GABEL AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-1007
Mailing Address - Country:US
Mailing Address - Phone:915-757-9441
Mailing Address - Fax:
Practice Address - Street 1:1101 N CAMPBELL ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4238
Practice Address - Country:US
Practice Address - Phone:915-747-8215
Practice Address - Fax:915-747-8211
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1036358225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist