Healthcare Provider Details

I. General information

NPI: 1790632768
Provider Name (Legal Business Name): SYDNEY NICOLE ADAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 E FOREMASTER DR BLDG B
ST GEORGE UT
84790-4510
US

IV. Provider business mailing address

271 S 100 W APT 4
ST GEORGE UT
84770-3457
US

V. Phone/Fax

Practice location:
  • Phone: 435-674-5195
  • Fax:
Mailing address:
  • Phone: 509-630-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14266835-2401
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: