Healthcare Provider Details

I. General information

NPI: 1760815336
Provider Name (Legal Business Name): ADAM ANTHONY ZUCHARA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2013
Last Update Date: 08/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 CAPITOL LANDING RD
WILLIAMSBURG VA
23185-4347
US

IV. Provider business mailing address

5996 ALLEGHENY RD
WILLIAMSBURG VA
23188-7369
US

V. Phone/Fax

Practice location:
  • Phone: 757-754-2480
  • Fax:
Mailing address:
  • Phone: 757-645-2657
  • Fax: 757-645-2657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305203168
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: