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General NPI Number Information
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NPI Number | 1730870445
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Entity Type | Individual
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Provider Name | ALIZABETH BESONDY QUILLEN ADAMS
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Gender | Female
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 10500 MONTGOMERY RD
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City | MONTGOMERY
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State | OH
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Zip | 45242-4402
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Country | US
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Telephone | 513-865-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 342 BONNIE LESLIE AVE
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City | BELLEVUE
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State | KY
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Zip | 41073-1718
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Country | US
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Telephone | 419-296-3012
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT020429
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License Number State | OH
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