Healthcare Provider Details

I. General information

NPI: 1770229718
Provider Name (Legal Business Name): KRISTEN N ADAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN N MAFFEI BS

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 FOREST DR STE 2
COLUMBIA SC
29206-3118
US

IV. Provider business mailing address

74 HAMPTON SPRINGS CT
COLUMBIA SC
29209-1844
US

V. Phone/Fax

Practice location:
  • Phone: 803-376-9789
  • Fax:
Mailing address:
  • Phone: 803-606-1079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.13229PT
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTT38657
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: