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Individual

LARRY E DIXON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.S.A.C.

Contact information

Practice address
58 E MAIN ST STE 7, DELTA, UT 84624-9500
(435) 979-6372
(435) 864-1669
Mailing address
PO BOX 387, DELTA, UT 84624-0387
(435) 979-6372
(435) 864-1669

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
331882-6006
UT

Other

Enumeration date
02/01/2009
Last updated
02/01/2009
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