Provider Demographics
NPI:1407242175
Name:RYBOLT, ABBIE
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:RYBOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:FLOREA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1326 EISENHOWER DR BLDG 1
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3928
Mailing Address - Country:US
Mailing Address - Phone:912-691-4100
Mailing Address - Fax:
Practice Address - Street 1:1326 EISENHOWER DR STE A
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-691-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD007115133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered