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Individual

MS. CAROL LYNN DIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
1952 E 7000 S, SLC, UT 84121
(801) 942-3311
(801) 942-5595
Mailing address
PO BOX 712252, SLC, UT 84171
(801) 943-2396

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1155622401
UT
225100000X
Physical Therapist
PT27201
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
N0615
UT
Enumeration date
11/15/2006
Last updated
07/08/2007
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