Individual
DILLON JAY REIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 N RENAISSANCE BLVD NE STE C, ALBUQUERQUE, NM 87107-7002
(505) 266-5565
Mailing address
1500 N RENAISSANCE BLVD NE STE C, ALBUQUERQUE, NM 87107-7002
(505) 266-5565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2021-0071
NM
363AM0700X
Medical Physician Assistant
Primary
PA.0007286
CO
Other
Enumeration date
01/15/2020
Last updated
10/23/2024
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