Dibacco, John M.
Dibacco, John M. is an individual health care provider with primary practice located at 911 Gorman Ave Ste 103, Elkins WV 26241-3154. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Dibacco, John M. can be contacted via phone (304) 636-1548.Contact Information
Primary practice address
911 Gorman Ave Ste 103
Elkins WV 26241-3154
Phone: (304) 636-1548
Fax: (304) 636-1566
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 001857 | West Virginia |
Profile Details
| NPI number | 1275536906 |
|---|---|
| LBN Legal business name | Dibacco, John M. |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 27th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275536906 | NPPES |
| West Virginia | MEDICAID | 0150180000 |
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