Individual
DEZRICK OMONT DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
112 BROADWAY ST, DURHAM, NC 27701-2402
(919) 949-3330
Mailing address
4207 ORAN AVE APT B, DURHAM, NC 27704-8032
(919) 949-3330
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2025-13014-01
NC
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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