Dillon Ivan

NPI #1053898510 in Waterbury, Connecticut

Provider Information

NPI Number: 1053898510
Entity Type: Individual
Name: Dillon Ivan
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jul 26, 2018
Last Updated: Jul 26, 2018

Practice Location

Address: 22 TOMPKINS ST
City: Waterbury
State: Connecticut
ZIP Code: 06708-1458
Phone: (203) 419-0381

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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