Provider Demographics
NPI:1003095928
Name:HARRISON, DAWNELLA GRACE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:DAWNELLA
Middle Name:GRACE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:MR
Other - First Name:DAWNELLA
Other - Middle Name:GRACE
Other - Last Name:MCLAREN-HARRISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:3455 JOHNSON FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5206
Mailing Address - Country:US
Mailing Address - Phone:770-998-6636
Mailing Address - Fax:
Practice Address - Street 1:3455 JOHNSON FERRY RD NE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5206
Practice Address - Country:US
Practice Address - Phone:770-998-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-27
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT008700225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist