Provider Demographics
NPI:1255049896
Name:DILLMAN, ROBERT COLE (RDN)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:COLE
Last Name:DILLMAN
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11417 STATE ROUTE 92
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-9125
Mailing Address - Country:US
Mailing Address - Phone:918-417-5200
Mailing Address - Fax:
Practice Address - Street 1:11417 STATE ROUTE 92
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-9125
Practice Address - Country:US
Practice Address - Phone:918-417-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2813133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered