Provider Demographics
NPI:1437431384
Name:TILLOTSON, ALAN (LAC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:TILLOTSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-2235
Mailing Address - Country:US
Mailing Address - Phone:302-994-0565
Mailing Address - Fax:
Practice Address - Street 1:1008 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2235
Practice Address - Country:US
Practice Address - Phone:302-994-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECQ-0000003171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist