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General NPI Number Information
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NPI Number | 1568610236
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Entity Type | Individual
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Provider Name | BERNITA DIXON
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Gender | Female
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 3720 DAUPHIN ST
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City | MOBILE
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State | AL
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Zip | 36608-1725
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Country | US
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Telephone | 251-621-4466
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 APEX DR
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City | MOBILE
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State | AL
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Zip | 36693-4910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 19054 PTA9009
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License Number State | AL
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