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1215419759
JEREMY ALLEN DIXON
KINGWOOD, WV
NPI
1215419759
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WV AT001143)
Enumeration Date
2018-08-31
Last Update Date
2018-08-31
Business Address
JEREMY ALLEN DIXON ATC
150 MEMORIAL DR
KINGWOOD, WV 26537-1141
Phone number: 304-329-1400
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Mailing Address
JEREMY ALLEN DIXON ATC
49 MILFORD LN
KINGWOOD, WV 26537-8310
Phone number:
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