Provider Demographics
NPI:1760509327
Name:MORGAN, JANNA DEHLER (PT)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:DEHLER
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:DENISE
Other - Last Name:DEHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3532
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-3532
Mailing Address - Country:US
Mailing Address - Phone:404-229-4874
Mailing Address - Fax:
Practice Address - Street 1:114 NEW ST
Practice Address - Street 2:SUITE I-2
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4132
Practice Address - Country:US
Practice Address - Phone:404-229-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0011922251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA214173674BMedicaid
GA214173674AMedicaid