Healthcare Provider Details

I. General information

NPI: 1184947467
Provider Name (Legal Business Name): CHRISTINE ELLEN ADAMS MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2994 BROOKS DR
SNELLVILLE GA
30078-3541
US

IV. Provider business mailing address

2994 BROOKS DR
SNELLVILLE GA
30078-3541
US

V. Phone/Fax

Practice location:
  • Phone: 678-896-0818
  • Fax: 770-558-3861
Mailing address:
  • Phone: 678-896-0818
  • Fax: 770-558-3861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004460
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: