Individual
MR. CHAD RYAN DYBDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
1575 INDIAN TRAIL LILBURN RD, NORCROSS, GA 30093-2614
(770) 243-2000
Mailing address
368 W WIND DR SW, LILBURN, GA 30047-6429
(770) 717-8867
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000532
GA
Other
Enumeration date
09/12/2006
Last updated
07/08/2007
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