Individual
ELLEN DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
873 TIMBERVIEW AVE, SPRINGFIELD, OH 45502-7963
(937) 408-7050
Mailing address
873 TIMBERVIEW AVE, SPRINGFIELD, OH 45502-7963
(937) 408-7050
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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