MEDICARE: DYNAMIC PT & REHAB, INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154329464
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC PT & REHAB, INC

Provider Business Mailing Address
First Line	:	262 HIGHWAY 515
Second Line	:	SUITE C
City	:	BLAIRSVILLE
State	:	GA
Zip	:	30512-3585
Country	:	US
Telephone Number	:	706-781-2875
Fax Number	:	706-781-2876

Provider Business Practice Location Address
First Line	:	262 HIGHWAY 515
Second Line	:	SUITE C
City	:	BLAIRSVILLE
State	:	GA
Zip	:	30512-3585
Country	:	US
Telephone Number	:	706-781-2875
Fax Number	:	706-781-2876

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	KELLY MOORE SCHILLER
Credential	:	MPT
Telephone Number	:	706-781-2875

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	08/22/2020

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Directions to “DYNAMIC PT & REHAB, INC ” Practice Location

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