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NPI Code Detail

MEDICARE: DR. NATHAN RYAN ADAMCZAK DPT, ATC-L, CSCS

MEDICARE: DR. NATHAN RYAN ADAMCZAK DPT, ATC-L, CSCS
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
12251X0800XOrthopedic Physical Therapist13728NC

General Provider Information

NPI Number : 1598013922
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN RYAN ADAMCZAK DPT, ATC-L, CSCS
Provider Business Mailing Address
First Line : 1001 VAN BUREN AVE
Second Line : SUITE 3
City : INDIAN TRAIL
State : NC
Zip : 28079-5541
Country : US
Telephone Number : 704-628-6053
Fax Number :
Provider Business Practice Location Address
First Line : 1001 VAN BUREN AVE
Second Line : SUITE 3
City : INDIAN TRAIL
State : NC
Zip : 28079-5541
Country : US
Telephone Number : 704-628-6053
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2012
Last Update Date : 08/15/2012

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