Derryl S. Dickerson
Rehabilitation Chiropractor Physical Therapy Assistant
2850 Johnson Ferry Rd Ste 150
Marietta
, Georgia 30062-8317
Derryl S. Dickerson
Rehabilitation Chiropractor Physical Therapy Assistant
2850 Johnson Ferry Rd Ste 150
Marietta
, Georgia 30062-8317
(256) 225-0495
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About
Features
Specialties
- Rehabilitation Chiropractor
- Physical Therapy Assistant
Languages spoken
- English
Location
First Address
- Derryl S. Dickerson
- 1720 Windcliff Dr Se
- Marietta, GA
- Zip : 30067-3801
- Phone : (256) 225-0495
Second Address
- Derryl S. Dickerson
- 2850 Johnson Ferry Rd Ste 150
- Marietta, GA
- Zip : 30062-8317
- Phone : (770) 518-8786
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Is Derryl S. Dickerson a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NR0400X | Rehabilitation Chiropractor | CHIR010363 | GA |
| N | 225200000X | Physical Therapy Assistant | PTA002699 | GA |
National Provider Identifier
| NPI | 1316253107 |
|---|---|
| Provider Name | Derryl S. Dickerson |
| First Address | Marietta, GA 30067-3801 |
| Second Address | Marietta, GA 30062-8317 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/08/2010 |
| Last Update Date | 21/05/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.