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:
Health care specialties
| Specialty | Code | License # | 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 15 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 | 1366648719 | NPPES |
| Georgia | Other | 1518959006 | DR. BENDIKS |
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