Healthcare Provider Details

I. General information

NPI: 1649006172
Provider Name (Legal Business Name): JOY SMITH PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

487 WINN WAY STE 150
DECATUR GA
30030-1735
US

IV. Provider business mailing address

487 WINN WAY STE 150
DECATUR GA
30030-1735
US

V. Phone/Fax

Practice location:
  • Phone: 404-251-2007
  • Fax: 404-544-9875
Mailing address:
  • Phone: 404-251-2007
  • Fax: 404-544-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017379
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: