Provider Demographics
NPI:1518450303
Name:DREAMWORX PT LLC
Entity Type:Organization
Organization Name:DREAMWORX PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DARONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:770-485-2891
Mailing Address - Street 1:2424 STEINBECK LN
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5099
Mailing Address - Country:US
Mailing Address - Phone:904-742-7177
Mailing Address - Fax:
Practice Address - Street 1:2650 DALLAS HWY SW STE 210
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-7508
Practice Address - Country:US
Practice Address - Phone:770-485-2891
Practice Address - Fax:678-695-7983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy