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NPI Code Detail

MEDICARE: SARA E ADAMS PT

MEDICARE: SARA E ADAMS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist4758WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255329983
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA E ADAMS PT
Provider Business Mailing Address
First Line : 1760 SHAWANO AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3216
Country : US
Telephone Number : 920-499-5191
Fax Number :
Provider Business Practice Location Address
First Line : 1760 SHAWANO AVE
Second Line :
City : GREEN BAY
State : WI
Zip : 54303-3216
Country : US
Telephone Number : 920-499-5191
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 05/15/2008

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Directions to “ SARA E ADAMS PT” Practice Location

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