Provider Demographics
NPI:1164514022
Name:DIXON, RUTH ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ELIZABETH
Last Name:DIXON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RUSH
Other - Middle Name:ELIZABETH
Other - Last Name:DUNNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3200 N RICHMOND ST
Mailing Address - Street 2:RUTH E DIXON DC
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911
Mailing Address - Country:US
Mailing Address - Phone:920-731-0599
Mailing Address - Fax:920-731-0599
Practice Address - Street 1:3200 N RICHMOND ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911
Practice Address - Country:US
Practice Address - Phone:920-731-0599
Practice Address - Fax:920-731-0599
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38869200Medicaid
WI38869200Medicaid