Individual
DILLON DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Contact information
Practice address
1925 GIANTS DR, EAST RUTHERFORD, NJ 07073-2140
(201) 935-8111
Mailing address
100 SCHINDLER CT APT 166, EAST RUTHERFORD, NJ 07073-2173
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
40QA02176600
NJ
2255A2300X
Athletic Trainer
Primary
25MT00315800
NJ
Other
Enumeration date
06/12/2020
Last updated
04/18/2024
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