Individual
MR. WILLIE NATHANIEL DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2817 TILGHMAN RD N, WILSON, NC 27896-8908
(252) 243-9827
(252) 291-9448
Mailing address
2817 TILGHMAN RD N, WILSON, NC 27896-8908
(252) 243-9827
(252) 291-9448
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-098-009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801424
—
NC
Enumeration date
03/13/2007
Last updated
07/09/2007
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