Healthcare Provider Details

I. General information

NPI: 1568622306
Provider Name (Legal Business Name): DEBRA ADAMS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 TEN ROD RD BOX 4
NORTH KINGSTOWN RI
02852-4236
US

IV. Provider business mailing address

610 TEN ROD RD BOX 4
NORTH KINGSTOWN RI
02852-4236
US

V. Phone/Fax

Practice location:
  • Phone: 401-295-9767
  • Fax: 401-295-0230
Mailing address:
  • Phone: 401-295-9767
  • Fax: 401-295-0230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number467
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: