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Dynamic Change

NPI Registration Record

Provider / OrganizationNPIDate Certified
DYNAMIC CHANGE15488687302020-10-11
Entity TypeOrganization
Provider OrganizationDYNAMIC CHANGE
Practice Office Address2255 CUMBERLAND PKWY SE STE 240
ATLANTA, GA US
Practice Office Telephone4703476896
Mailing Address1102 WESTCHASE LN SW APT 910
ATLANTA, GA 303364427 US
Business Telephone4042747408
Authorized OfficialCANDRA THOMAS, OWNER/ THERAPIS
4703476896
HPT Codes
CodeLicense NoState
101Y00000X
101YA0400X
101YP2500X
101YM0800X PRIMARY
193200000X MULTGroup Code
193200000X MULTGroup Code
193200000X MULTGroup Code
193200000X MULTGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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