Individual
DR. GREGORY A DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2191 KENWARD CT SW, MARIETTA, GA 30064-4813
(904) 377-1174
Mailing address
1101 WYNFORD COMMONS SW, MARIETTA, GA 30064-3776
(904) 377-1174
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT008718
GA
225X00000X
Occupational Therapist
OT004504
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511I650305
MEDICARE PROVIDER NUMBER
GA
Enumeration date
03/22/2007
Last updated
01/20/2009
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