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NPI Code Detail

MEDICARE: DANA S GILLIS PT

MEDICARE: DANA S GILLIS PT
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
1225100000XPhysical Therapist008078GA

General Provider Information

NPI Number : 1184781148
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA S GILLIS PT
Provider Business Mailing Address
First Line : 1958 MENDENHALL ST
Second Line :
City : CHAMBLEE
State : GA
Zip : 30341-2007
Country : US
Telephone Number : 404-247-7959
Fax Number : 404-459-6566
Provider Business Practice Location Address
First Line : 1123 OXFORD CRES NE
Second Line :
City : ATLANTA
State : GA
Zip : 30319-1624
Country : US
Telephone Number : 404-247-7959
Fax Number : 404-459-6566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/08/2007

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Directions to “ DANA S GILLIS PT” Practice Location

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