Basic Information
Provider Information
NPI: 1063495430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DILL
FirstName: FRANKLIN
MiddleName: CHARLES
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 GARDEN RD
Address2:  
City: MONTEREY
State: CA
PostalCode: 939405313
CountryCode: US
TelephoneNumber: 8313751885
FaxNumber: 8313757436
Practice Location
Address1: 350 BOLLINGER CANYON LN
Address2: SUITE A
City: SAN RAMON
State: CA
PostalCode: 945824592
CountryCode: US
TelephoneNumber: 9257356414
FaxNumber: 9257356450
Other Information
ProviderEnumerationDate: 11/21/2005
LastUpdateDate: 03/29/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT 25425CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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