Provider Demographics
NPI:1831776319
Name:RAMOS, DENNIS (DPT)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:RAMOS
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 1:500 EAGLE LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-2246
Mailing Address - Country:US
Mailing Address - Phone:478-733-1030
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:500 EAGLE LAKE TRL
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2246
Practice Address - Country:US
Practice Address - Phone:478-733-1030
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT012428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist