MEDICARE: DREAMWORX PT LLC

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1518450303
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DREAMWORX PT LLC

Provider Business Mailing Address
First Line	:	2424 STEINBECK LN
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-5099
Country	:	US
Telephone Number	:	904-742-7177
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 DALLAS HWY SW STE 210
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-7508
Country	:	US
Telephone Number	:	770-485-2891
Fax Number	:	678-695-7983

Authorized Official
Title or Position	:	OWNER, PHYSICAL THERAPIST
Name	:	DARONNE JENKINS
Credential	:	DPT
Telephone Number	:	770-485-2891

Provider Enumeration Date	:	06/07/2018
Last Update Date	:	08/04/2020

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Directions to “DREAMWORX PT LLC ” Practice Location

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