Provider Demographics
NPI:1811242993
Name:FLECK, JOHN DAVIS (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVIS
Last Name:FLECK
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 WINN WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1736
Mailing Address - Country:US
Mailing Address - Phone:404-294-1313
Mailing Address - Fax:404-294-1318
Practice Address - Street 1:495 WINN WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1736
Practice Address - Country:US
Practice Address - Phone:404-294-1313
Practice Address - Fax:404-294-1318
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist