Provider Demographics
NPI:1184486326
Name:JAMIAH, JOSHUA NATHANAEL (DPT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:NATHANAEL
Last Name:JAMIAH
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 1:3945 WOODRIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2159
Mailing Address - Country:US
Mailing Address - Phone:404-234-6619
Mailing Address - Fax:
Practice Address - Street 1:4025 JOHNS CREEK PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-5683
Practice Address - Country:US
Practice Address - Phone:404-575-4505
Practice Address - Fax:678-933-0472
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT016976OtherGA STATE LICENSE