| Dynamic 1 Medical And Rehab Clinic | |
|
2015 Martin Luther King Jr Drive Suite B Atlanta GA 30310 | |
| (678) 705-1733 | |
| (404) 254-0529 |
| Full Name | Dynamic 1 Medical And Rehab Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 2015 Martin Luther King Jr Drive Suite B, Atlanta, Georgia |
| Authorized Official Name and Position | Dale Adrian Carey (CO OWNER) |
| Authorized Official Contact | 6787051733 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic 1 Medical And Rehab Clinic 2015 Martin Luther King Jr Drive Suite B Atlanta GA 30310 Ph: (678) 705-1733 | Dynamic 1 Medical And Rehab Clinic 2015 Martin Luther King Jr Drive Suite B Atlanta GA 30310 Ph: (678) 705-1733 |
| NPI Number | 1861788986 |
|---|---|
| Provider Enumeration Date | 06/27/2011 |
| Last Update Date | 10/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861788986 | NPI | - | NPPES |
| 000299868J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | 026238 (Georgia) | Secondary |
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