Provider Demographics
NPI:1013547892
Name:SAMS, DARIUS L (DPT)
Entity Type:Individual
Prefix:
First Name:DARIUS
Middle Name:L
Last Name:SAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-3893
Mailing Address - Country:US
Mailing Address - Phone:678-447-7988
Mailing Address - Fax:
Practice Address - Street 1:3410 FLORENCE CIR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6052
Practice Address - Country:US
Practice Address - Phone:470-222-3051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012707225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist