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NPI 1477471290

NPI 1477471290 : JESSECA GABRIEL LINDSEY DPT : SMYRNA, GA

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General NPI Number Information
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    NPI Number           |    1477471290
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    Entity Type          |    Individual 
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    Provider Name        |    JESSECA GABRIEL LINDSEY DPT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/08/2026
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    Last Update Date     |    07/08/2026
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Provider Practice Location Address
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    Address Line         |    3200 HIGHLANDS PKWY SE STE 150 
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    City                 |    SMYRNA
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    State                |    GA
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    Zip                  |    30082-5191
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    Country              |    US
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    Telephone            |    770-927-7424
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3184 MANGUM LN SW 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30311-3046
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    Country              |    US
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    Telephone            |    404-518-0771
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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        |    2251P0200X
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    Taxonomy Name        |    Pediatric Physical Therapist
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    License Number       |    PT018426
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    License Number State |    GA
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