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General NPI Number Information
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NPI Number | 1780713610
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Entity Type | Individual
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Provider Name | JOSEPH LEE DIBBLE R.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 171 CAMPBELL LN
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City | YERINGTON
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State | NV
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Zip | 89447-9731
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Country | US
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Telephone | 775-463-3335
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Fax |
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Provider Business Mailing Address
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Address Line | 5499 BREEZE CT
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City | SUN VALLEY
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State | NV
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Zip | 89433-6505
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Country | US
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Telephone | 775-673-8630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NV
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