Provider Demographics
NPI:1174911432
Name:DILBECK, LINDSAY MARIE (ATC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:DILBECK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:COPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:204 RUSSELL WOODS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:GA
Mailing Address - Zip Code:30563-4179
Mailing Address - Country:US
Mailing Address - Phone:706-968-7435
Mailing Address - Fax:
Practice Address - Street 1:2059 HIGHWAY 197
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:GA
Practice Address - Zip Code:30563-3441
Practice Address - Country:US
Practice Address - Phone:706-778-7161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0024662255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer