MS. HOLLY JOY DIBERT ATC NPI 1366648719

NPI Information

NPI: 1366648719
Provider Name: MS. HOLLY JOY DIBERT, ATC
Classification: - 246ZS0400X
Entity Type: Individual
Address:
1014 SYCAMORE DR STE B
DECATUR, GA
ZIP 30030
Phone: (404) 299-1700
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MS. Holly Joy Dibert, ATC is a healthcare provider in Decatur, GA. MS. Holly Joy Dibert, ATC NPI is 1366648719. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1014 SYCAMORE DR STE B
DECATUR, GA
ZIP 30030-644
Phone: (404) 299-1700
Fax: (404) 299-1616

The enumeration date for this NPI number is 6/22/2007 and was last updated on 10/31/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	174400000X	Specialist	00300	IOWA	No
2	174400000X	Specialist	1835	MINNESOTA	No
3	246ZS0400X		10-0825	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GRP2711	MEDICARE UPIN	GEORGIA
2	1518959006	OTHER	GEORGIA	DR. BENDIKS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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