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General NPI Number Information
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NPI Number | 1174478333
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Entity Type | Organization
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Legal Business Name | SCOTT DOSS WELLNESS DBA STAR DYNAMIC WELLNESS
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 125 E TRINITY PL STE 306
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City | DECATUR
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State | GA
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Zip | 30030-3360
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Country | US
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Telephone | 404-937-6234
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Fax |
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Provider Business Mailing Address
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Address Line | 454 BLAKE AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-1720
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Country | US
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Telephone | 404-937-6234
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SCOTT OGLESBAY
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Credential | OMT, LMT, BCTMB
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Telephone | 404-937-6234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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