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General NPI Number Information
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NPI Number | 1174839419
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Entity Type | Individual
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Provider Name | HEATHER ADAMS LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 567 N 5TH ST STUDENT SERVICES BUILDING, 246
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City | TERRE HAUTE
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State | IN
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Zip | 47809-1903
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Country | US
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Telephone | 608-577-1314
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Fax |
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Provider Business Mailing Address
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Address Line | 5425 CANNON CT APT E
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City | TERRE HAUTE
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State | IN
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Zip | 47803-4270
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36001729A
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License Number State | IN
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