Provider Demographics
NPI:1942029640
Name:DHILLON, CELIA ROSE
Entity type:Individual
Prefix:MISS
First Name:CELIA
Middle Name:ROSE
Last Name:DHILLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 E KIRBY STREET
Mailing Address - Street 2:APT 107
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:206-432-0445
Mailing Address - Fax:
Practice Address - Street 1:1423 FIELD STREET
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-2321
Practice Address - Country:US
Practice Address - Phone:313-924-7860
Practice Address - Fax:313-924-0350
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist