Dibert, Holly Joy

Dibert, Holly Joy is an sole proprietor health care provider with primary practice located at 1014 Sycamore Dr Ste B , Decatur GA 30030-1644. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Technologists, Technicians & Other Technical Service Providers / Surgical Technologist. Technologists, Technicians & Other Technical Service Providers / Surgical Technologist is her primary health care specialty. Dibert, Holly Joy can be contacted via phone (404) 299-1700.

Contact Information

Primary practice address
1014 Sycamore Dr Ste B Decatur GA 30030-1644
Phone: (404) 299-1700
Fax: (404) 299-1616
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 00300 Iowa
Other Service Providers / Specialist 174400000X 1835 Minnesota
Technologists, Technicians & Other Technical Service Providers / Surgical Technologist 246ZS0410X 10-0825 Georgia

Profile Details

NPI number 1366648719
LBN Legal business name Dibert, Holly Joy
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2007
Last updated Oct 31st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366648719 NPPES
Georgia Other 1518959006 DR. BENDIKS

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