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1902264492
TY-RE LAMONT DIXON
FAYETTEVILLE, GA
NPI
1902264492
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment
Enumeration Date
2016-01-29
Last Update Date
2016-01-29
Business Address
Mr. TY-RE LAMONT DIXON
220 SHORELINE DR.
FAYETTEVILLE, GA 30215
Phone number: 404-661-1800
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Mailing Address
Mr. TY-RE LAMONT DIXON
220 SHORELINE DR.
FAYETTEVILLE, GA 30215
Phone number: 404-661-1800
Copy
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