Dibauda, James Michael

Dibauda, James Michael is an sole proprietor health care provider with primary practice located at 202 Village Dr , Lagrange GA 30240-8831. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Dibauda, James Michael can be contacted via phone (706) 884-6403.

Contact Information

Primary practice address
202 Village Dr Lagrange GA 30240-8831
Phone: (706) 884-6403
Fax: (706) 884-6403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT004061 Georgia

Profile Details

NPI number 1356335293
LBN Legal business name Dibauda, James Michael
Credentials OTRL
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2005
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356335293 NPPES
Georgia Other 3963141 AETNA PROVIDER NUMBER

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