Doctor Name: | ANDREW BLAIR DACRES |
NPI Number: | 1720329295 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMT |
License Number: | MT006007 |
Business Practice Address: | 3300 N E Expy Ne Ste C Atlanta, GA - 303413932 |
Business Phone Number: | 7705003848 |
Business Fax Number: | 6788681114 |
Mailing Address: | 3629 Linecrest Trl, ELLENWOOD |
State: | GA |
Postal Code: | 302941972 |
Phone Number: | 7703340818 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2013 |
NPI Last Update Date: | 03/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT006007 |
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. |