Healthcare Provider Details

I. General information

NPI: 1871381616
Provider Name (Legal Business Name): ADAM ROBERT SHEETZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 MURRAH DR
ROCK HILL SC
29732-2342
US

IV. Provider business mailing address

127 MURRAH DR
ROCK HILL SC
29732-2342
US

V. Phone/Fax

Practice location:
  • Phone: 803-328-6518
  • Fax:
Mailing address:
  • Phone: 301-992-0105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code226000000X
TaxonomyRecreational Therapist Assistant
License Number4852
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: