Organization
PROACTIVE ATHLETIC PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL W BODKIN PT, DPT, ATC (OWNER / PHYSICAL THERAPIST)
(580) 917-6326
Entity
Organization
Contact information
Practice address
9 DUNWOODY PARK SOUTH # 14, DUNWOODY, GA 30338-7407
(580) 917-6326
Mailing address
9 DUNWOODY PARK SOUTH # 14, DUNWOODY, GA 30338-7407
(580) 917-6326
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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