Individual
JEREMY ALLEN DIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
150 MEMORIAL DR, KINGWOOD, WV 26537-1141
(304) 329-1400
Mailing address
49 MILFORD LN, KINGWOOD, WV 26537-8310
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001143
WV
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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