Individual
CODY BLAKE DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1908 GLENWOOD PARK RD, PRINCETON, WV 24739-7969
(304) 323-2300
Mailing address
526 WHITE PINES RD, PRINCETON, WV 24739-8750
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002418
WV
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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