Healthcare Provider Details

I. General information

NPI: 1891275889
Provider Name (Legal Business Name): WENDY ADAMO PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2018
Last Update Date: 08/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 WOODGATE DR
WACO TX
76712-8600
US

IV. Provider business mailing address

9116 WOLF CREEK DR
WACO TX
76712-8738
US

V. Phone/Fax

Practice location:
  • Phone: 254-666-5454
  • Fax:
Mailing address:
  • Phone: 254-855-9652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1053593
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: