MEDICARE: DANYKIA CHANDRELLE PERINE 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
1	2255A2300X	Athletic Trainer	AT001928	GA
2	225100000X	Physical Therapist	PT018117	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PT018117	OTHER	GA	LICENSE
2	AT001928	OTHER	GA	LICENSE

General Provider Information

NPI Number	:	1730674292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANYKIA CHANDRELLE PERINE PT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-702-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 CONCORD RD SE STE 210
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-4255
Country	:	US
Telephone Number	:	678-293-0250
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	12/19/2025

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Directions to “ DANYKIA CHANDRELLE PERINE PT” Practice Location

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