Mr. Ty-Re Lamont Dixon Sr.
Mr. Ty-Re Lamont Dixon Sr. is a Customized Equipment (DME) in Fayetteville, Georgia. Practices as a sole proprietor. Licensed in Georgia.
- Licensed in
- GA
- In the registry since
- 2016
Practice location Address checks out
220 Shoreline DrFayetteville, GA 30215
Phone: (404) 661-1800
Fax: (770) 897-3777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Customized Equipment (DME) (primary) | Taxonomy 332BC3200X (GA) |
|---|
Record details
| NPI number | 1902264492 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | January 29, 2016 |
| Last updated in NPPES | January 29, 2016 |