Shane Keith Dillon
Technician, Personal Care Attendant in Red Jacket, WV. Individual provider (NPI-1).
NPI number1982203725
StatusActive
Last updated in NPPESOct 22, 2020
Details
- NPI
- 1982203725
- Entity type
- Individual (NPI-1)
- Name
- Shane Keith Dillon
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 22, 2020
- Certification date
- Oct 21, 2020
- Last updated
- Oct 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
Shop Hollow Route 6 Mate CreekRed Jacket, WV 25692
Phone 304-426-4722
Mailing address
Po Box 80Red Jacket, WV 25692-0080
Phone 304-426-4722
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