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General NPI Number Information
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NPI Number | 1639938335
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Entity Type | Individual
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Provider Name | DAKOTA HAYES
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Gender | Male
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 999 BRADY AVE NW STE 11
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City | ATLANTA
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State | GA
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Zip | 30318-5607
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Country | US
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Telephone | 678-459-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 18022 LEE LN
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City | HOLT
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State | MO
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Zip | 64048-8113
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Country | US
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Telephone | 816-835-6543
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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