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Individual

GEORGE DICOLA I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ST

Contact information

Practice address
1903 S HAWTHORNE RD, EDWIN H. MARTINAT COMPREHENSIVE REHABILITATION CENTER, WINSTON-SALEM, NC 27103-3916
(336) 718-6700
Mailing address
2000 FRONTIS PLAZA BLVD STE 200, (ATTN) FORSYTH MEDICAL GROUP, WINSTON SALEM, NC 27103-5616
(336) 277-2435
(336) 277-9275

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
845
NC

Other

Enumeration date
04/06/2006
Last updated
07/08/2007
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