Doctor Name: | MR. JIMMY NEWT DYER |
NPI Number: | 1023440328 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MT009204 |
License Number: | MT009204 |
Business Practice Address: | 1510 N Thornton Ave 214 Dalton, GA - 307208517 |
Business Phone Number: | 7062750543 |
Business Fax Number: | |
Mailing Address: | 1510 N Thornton Ave, 214 DALTON |
State: | GA |
Postal Code: | 307208517 |
Phone Number: | 7062750543 |
Fax Number: | |
NPI Enumeration Date: | 08/08/2013 |
NPI Last Update Date: | 08/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT009204 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |