Most Relevant Information
Provider Data
| NPI Number: | 1003357005 |
| Provider Name: | DILLON JOHN FASSE LAT, ATC |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 1929-39 |
Most Important Dates
| Enumeration Date: | 03/10/2017 |
| Last Updated: | 03/10/2017 |
Provider Practice Location
W156N9000 PILGRIM RD
MENOMONEE FALLS
WI
530512272
Practice Location Phone/Fax
| Phone: | 2625028752 |
| Fax: |
Provider Mailing Location
W290S4827 PARKE LN W
WAUKESHA
WI
531899047
Provider Mailing Phone/Fax
| Phone: | 2623917952 |
| Fax: |