MEDICARE: JULIA DYER

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	261QA0600X	Adult Day Care Clinic/Center		GA

General Provider Information

NPI Number	:	1235942301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA DYER

Provider Business Mailing Address
First Line	:	698 CARON CIR NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-6038
Country	:	US
Telephone Number	:	678-732-8764
Fax Number	:

Provider Business Practice Location Address
First Line	:	2740 JEFFERSON ST STE A1
Second Line	:
City	:	AUSTELL
State	:	GA
Zip	:	30168-4014
Country	:	US
Telephone Number	:	678-732-8764
Fax Number	:	678-732-8764

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

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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Directions to “ JULIA DYER ” Practice Location

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