Individual
DANIEL RUSTIN DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
641 VETERANS PKWY S, MOULTRIE, GA 31788-8843
(229) 985-6850
Mailing address
PO BOX 426, ADEL, GA 31620-0426
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
027636
GA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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