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NPI Code Detail

MEDICARE: ADAM'S THERAPY SERVICES PLLC

MEDICARE: ADAM'S THERAPY SERVICES PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1285139444
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADAM'S THERAPY SERVICES PLLC
Provider Business Mailing Address
First Line : 3002 WESTWARD DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75964-1207
Country : US
Telephone Number : 936-305-5104
Fax Number :
Provider Business Practice Location Address
First Line : 3002 WESTWARD DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75964-1207
Country : US
Telephone Number : 936-305-5104
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SHANE ADAM MYATT
Credential :
Telephone Number : 936-305-5104
Provider Enumeration Date : 03/28/2018
Last Update Date : 03/28/2018

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Directions to “ADAM'S THERAPY SERVICES PLLC ” Practice Location

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