Mr James Michael Dibauda, OTRL | |
202 Village Dr, Lagrange, GA 30240-8831 | |
(706) 884-6403 | |
(706) 884-6403 |
Full Name | Mr James Michael Dibauda |
---|---|
Gender | Male |
Speciality | Occupational Therapist |
Location | 202 Village Dr, Lagrange, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356335293 | NPI | - | NPPES |
3963141 | Other | GA | AETNA PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT004061 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr James Michael Dibauda, OTRL 202 Village Dr, Lagrange, GA 30240-8831 Ph: (706) 884-6403 | Mr James Michael Dibauda, OTRL 202 Village Dr, Lagrange, GA 30240-8831 Ph: (706) 884-6403 |
Mrs. Christina Marie Jackson, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 316 N Lewis St, Lagrange, GA 30240 Phone: 205-478-1406 Fax: 866-812-9807 | |
Mark Terry Brown, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1514 Vernon Rd, Lagrange, GA 30240 Phone: 706-845-3677 | |
Michael Knight, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1514 Vernon Rd, Lagrange, GA 30240 Phone: 706-594-2490 |