Provider Demographics
NPI:1922174259
Name:DAHLEN, DAWN B (PT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:B
Last Name:DAHLEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 SPRUCE MANOR CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-9791
Mailing Address - Country:US
Mailing Address - Phone:678-493-3333
Mailing Address - Fax:
Practice Address - Street 1:7220 SCOTSHIRE WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7396
Practice Address - Country:US
Practice Address - Phone:678-206-6201
Practice Address - Fax:678-206-6201
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA53252251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20265I8113OtherMEDICARE PTAN