Healthcare Provider Details

I. General information

NPI: 1457160145
Provider Name (Legal Business Name): ADAM DUKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 RIVERSIDE DR
DUBLIN OH
43017-1492
US

IV. Provider business mailing address

6000 RIVERSIDE DR
DUBLIN OH
43017-1492
US

V. Phone/Fax

Practice location:
  • Phone: 614-764-1600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA008792
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: