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Individual

MRS. LANAN RAE DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1400 WASHINGTON ST, SUITE 3, TWO RIVERS, WI 54241-3043
(920) 553-8993
(920) 553-8990
Mailing address
1400 WASHINGTON ST, SUITE 3, TWO RIVERS, WI 54241-3043
(920) 553-8993
(920) 553-8990

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4947-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40295900
WI
Enumeration date
05/04/2007
Last updated
06/20/2008
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