Healthcare Provider Details

I. General information

NPI: 1225074016
Provider Name (Legal Business Name): ROBERT G DIXON P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 JEFFERSON HWY STE 102
LOUISA VA
23093-6563
US

IV. Provider business mailing address

PO BOX 412307
BOSTON MA
02241-2307
US

V. Phone/Fax

Practice location:
  • Phone: 540-967-1757
  • Fax: 540-967-0817
Mailing address:
  • Phone: 914-294-4050
  • Fax: 631-760-8306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305204390
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: