Individual
DR. MICHELLE ELISE DIBIASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
228 RIVERSIDE DR, WAYCROSS, GA 31501-3541
(912) 287-1414
(912) 287-1884
Mailing address
228 RIVERSIDE DR, WAYCROSS, GA 31501-3541
(912) 287-1414
(912) 287-1884
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006355
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
759966
BLUE CROSS BLUE SHIELD
GA
Enumeration date
08/30/2006
Last updated
07/08/2007
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