MEDICARE: DARYLL DUBAL P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT007707	GA

General Provider Information

NPI Number	:	1114096419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARYLL DUBAL P.T.

Provider Business Mailing Address
First Line	:	3985 STEVE REYNOLDS BLVD BLDG G
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30093-3001
Country	:	US
Telephone Number	:	770-622-2532
Fax Number	:	770-622-2534

Provider Business Practice Location Address
First Line	:	3985 STEVE REYNOLDS BLVD
Second Line	:	BLD G
City	:	NORCROSS
State	:	GA
Zip	:	30093-3035
Country	:	US
Telephone Number	:	770-622-2532
Fax Number	:	770-622-2534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	03/23/2012

Similar Medicare Providers

1003808312 — DR. TRUC THANH PHAM M.D.
Practice Location Address:

3985 STEVE REYNOLDS BLVD , SUITE K 102
NORCROSS, GA
30093-3035

Practice Phone: 678-367-0390
Practice Fax: 678-245-3391

1144294505 — DR. THANG NGUYEN D.O.
Practice Location Address:

3985 STEVE REYNOLDS BLVD , SUITE K-102
NORCROSS, GA
30093-3035

Practice Phone: 678-367-0390
Practice Fax: 678-245-3391

1831282326 — MR. WILLIAM DAVID MILLER LPC
Practice Location Address:

3985 STEVE REYNOLDS BLVD , BLDG B SUITE A
NORCROSS, GA
30093-3035

Practice Phone: 706-442-9127
Practice Fax: 678-921-0354

1063586170 — MR. NINO RENZO RENZO FORNASINI MD
Practice Location Address:

3985 STEVE REYNOLDS BLVD , BLDG I
NORCROSS, GA
30093-3035

Practice Phone: 770-622-3948
Practice Fax: 770-622-4879

1952469207 — MR. SERGIO O HERNANDEZ PT.
Practice Location Address:

3985 STEVE REYNOLDS BLVD , BLDG G.
NORCROSS, GA
30093-3035

Practice Phone: 770-622-2532
Practice Fax: 770-622-2534

1851415319 — PHUONG B LE DMD
Practice Location Address:

3985 STEVE REYNOLDS BLVD , BUILDING O, SUITE 101
NORCROSS, GA
30093-3035

Practice Phone: 678-205-1308
Practice Fax: 678-205-1345

Directions to “ DARYLL DUBAL P.T.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.