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General NPI Number Information
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NPI Number | 1407056724
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Entity Type | Individual
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Provider Name | BRIAN MATTHEW ADAMS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 697 EDGEWOOD RD
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City | WILKESBORO
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State | NC
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Zip | 28697-9562
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Country | US
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Telephone | 336-844-4249
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Fax | 336-844-4819
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Provider Business Mailing Address
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Address Line | PO BOX 1024
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City | NORTH WILKESBORO
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State | NC
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Zip | 28659-1024
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Country | US
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Telephone | 336-844-4249
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Fax | 336-844-4819
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 6541
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License Number State | NC
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