NPI 1275667115

Dennis Wayne Dillard, CPEDCTO

Practitioner Orthotic Fitter Peoria, IL

Practice location

Address: 741 W Main St, Peoria, IL 61606-2017
Phone: (309) 676-2276
Mailing address: 10823 W Smithville Rd, Hanna City, IL 61536-9711

Registered specialties

Orthotic Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225000000X Licence 212-000127 (IL)

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Registry record

NPI: 1275667115
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Mar 2007
Record last updated: 9 Nov 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.