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Organization

GIBRALTAR BIZ, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRITHA SKINNER DINWIDDIE RDN (OWNER)
(678) 485-3308
Entity
Organization

Contact information

Practice address
5505 E MOUNTAIN ST, STONE MOUNTAIN, GA 30083-3027
(678) 485-3308
Mailing address
5505 E MOUNTAIN ST, STONE MOUNTAIN, GA 30083-3027
(678) 485-3308

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093126997
GA
01
2273
STATE BOARD OF LICENSURE
KS
01
677280
COMMISSION ON DIETETIC REGISTRATION, ACADEMY OF NUTRITION AND DIETETICS
01
878
STATE BOARD OF LICENSURE
GA
01
893
STATE BOARD OF LICENSURE
AL
01
D1103
STATE BOARD OF LICENSURE
MS
01
DT85347
STATE BOARD OF LICENSURE
TX
01
L003247
STATE BOARD OF LICENSURE
NC
01
LDN2393
STATE BOARD OF LICENSURE
TN
01
ND9557
STATE BOARD OF LICENSURE
FL
Enumeration date
07/31/2021
Last updated
07/31/2021
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