Basic Information
| Provider Information | |||||||||
| NPI: | 1063971034 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BILLINGS | ||||||||
| FirstName: | DYLAN | ||||||||
| MiddleName: | KEITH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 284 SUNDANCE RD | ||||||||
| Address2: | |||||||||
| City: | EFFORT | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183308010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4845423125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 505 INDEPENDENCE RD | ||||||||
| Address2: | |||||||||
| City: | EAST STROUDSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 183017916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5704208080 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2019 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.