Provider Demographics
NPI:1255037230
Name:DRACIC, DAMIR (DPT)
Entity type:Individual
Prefix:
First Name:DAMIR
Middle Name:
Last Name:DRACIC
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 1:2 TRI COUNTY PLZ
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2700
Mailing Address - Country:US
Mailing Address - Phone:678-771-8977
Mailing Address - Fax:678-807-8695
Practice Address - Street 1:2 TRI COUNTY PLZ
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2700
Practice Address - Country:US
Practice Address - Phone:678-771-8977
Practice Address - Fax:678-807-8695
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT016410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist