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General NPI Number Information
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NPI Number | 1497237069
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Entity Type | Individual
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Provider Name | KAYLEE ADAMCIK
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Gender | Female
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Dates
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Enumeration Date | 08/30/2018
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Last Update Date | 08/30/2018
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Provider Practice Location Address
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Address Line | 151 COUNTRY MEADOWS BLVD
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City | WAXAHACHIE
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State | TX
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Zip | 75165-7811
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Country | US
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Telephone | 972-937-1650
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 CREECHVILLE RD
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City | ENNIS
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State | TX
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Zip | 75119-0308
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2135807
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License Number State | TX
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