Organization
DYNAMIC 1 MEDICAL AND REHAB CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE ADRIAN CAREY (CO OWNER)
(678) 705-1733
Entity
Organization
Contact information
Practice address
2015 MARTIN LUTHER KING JR DRIVE SUITE B, ATLANTA, GA 30310
(678) 705-1733
(404) 254-0529
Mailing address
2015 MARTIN LUTHER KING JR DRIVE SUITE B, ATLANTA, GA 30310
(678) 705-1733
(404) 254-0529
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
026238
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000299868J
—
GA
Enumeration date
06/27/2011
Last updated
10/26/2015
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