Provider Demographics
NPI:1366802506
Name:DOWDELL, TIFFANI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TIFFANI
Middle Name:
Last Name:DOWDELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MEADOW LAKES DR
Mailing Address - Street 2:
Mailing Address - City:PINE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:31822-3419
Mailing Address - Country:US
Mailing Address - Phone:706-615-7309
Mailing Address - Fax:
Practice Address - Street 1:506 MANCHESTER EXPY STE B1
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6443
Practice Address - Country:US
Practice Address - Phone:706-406-4033
Practice Address - Fax:706-558-3946
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26301225100000X
VA2305210430225100000X
DCPT872578225100000X
NC15992225100000X
GAPT014727225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist