Kyle Dixon

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Poland, OH

NPI 1083170658 · NPPES record last updated Feb 19, 2019

Key facts

NPI
1083170658
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
6064 Pawnee PL
Poland, OH 44514-1854
Phone
(330) 261-4387
NPI assigned
Feb 19, 2019
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes
Athletic Trainer 2255A2300X

Addresses

Primary practice location

6064 Pawnee PL
Poland, OH 44514-1854

Mailing address

6064 Pawnee PL
Poland, OH 44514-1854
Phone (330) 261-4387

Other providers in Poland, OH

All providers in Poland, OH · Student in an Organized Health Care Education/Training Program in Ohio

Sources for this page

Verify at the official NPI Registry.