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General NPI Number Information
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NPI Number | 1518450303
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Entity Type | Organization
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Legal Business Name | DREAMWORX PT LLC
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 2650 DALLAS HWY SW STE 210
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City | MARIETTA
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State | GA
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Zip | 30064-7508
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Country | US
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Telephone | 770-485-2891
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Fax | 678-695-7983
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Provider Business Mailing Address
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Address Line | 2424 STEINBECK LN
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-5099
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Country | US
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Telephone | 904-742-7177
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DARONNE JENKINS
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Credential | DPT
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Telephone | 770-485-2891
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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