Donna Jean Dillon, LMT

Individual provider Active NPI Massage Therapist · Magdalena, NM

NPI 1104609833 · NPPES record last updated Aug 16, 2023

Key facts

NPI
1104609833
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MT-2023-0005 (NM)
Practice address
103 St. Rd 107
Magdalena, NM 87825
Phone
(157) 551-8881
NPI assigned
Aug 16, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
MT-2023-0005NMMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225700000X MT-2023-0005 NM Yes

Addresses

Primary practice location

103 St. Rd 107
Magdalena, NM 87825

Mailing address

PO Box 331
Magdalena, NM 87825-0331
Phone (575) 518-8817

Other providers in Magdalena, NM

All providers in Magdalena, NM · Massage Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.