MEDICARE: MR. THOMAS N. ADAMS PTA

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
1	225200000X	Physical Therapy Assistant	PTA2096	AR

General Provider Information

NPI Number	:	1265655450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS N. ADAMS PTA

Provider Business Mailing Address
First Line	:	PO BOX 2398
Second Line	:
City	:	MOUNTAIN HOME
State	:	AR
Zip	:	72654-2398
Country	:	US
Telephone Number	:	870-701-5089
Fax Number	:	870-277-0896

Provider Business Practice Location Address
First Line	:	520 N. MAIN ST
Second Line	:
City	:	CAVE CITY
State	:	AR
Zip	:	72521-3533
Country	:	US
Telephone Number	:	870-283-6757
Fax Number	:	870-277-0896

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	04/12/2024

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