Healthcare Provider Details

I. General information

NPI: 1720840762
Provider Name (Legal Business Name): DYNAMIC EQUIPMENT AND REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 MCLINDEN AVE SE
SMYRNA GA
30080-4143
US

IV. Provider business mailing address

1021 MCLINDEN AVE SE
SMYRNA GA
30080-4143
US

V. Phone/Fax

Practice location:
  • Phone: 404-313-6368
  • Fax:
Mailing address:
  • Phone: 404-313-6368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MATT BAIR I
Title or Position: CEO
Credential:
Phone: 404-313-6368