Healthcare Provider Details

I. General information

NPI: 1164231882
Provider Name (Legal Business Name): DOMINIC ADAMS PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 RIVERBEND DR
SPRINGFIELD OR
97477-8800
US

IV. Provider business mailing address

221 SPRINGTREE LN
CIBOLO TX
78108-3444
US

V. Phone/Fax

Practice location:
  • Phone: 541-222-7300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP039319T
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1383061
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: