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NPI Code Detail

MEDICARE: KAELEIGH ADAMI DPT

MEDICARE: KAELEIGH ADAMI DPT
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 Therapist12917WI
2225100000XPhysical Therapist9616MN

General Provider Information

NPI Number : 1407250368
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAELEIGH ADAMI DPT
Provider Business Mailing Address
First Line : 1016 1ST ST N
Second Line :
City : STILLWATER
State : MN
Zip : 55082-4066
Country : US
Telephone Number : 651-260-3675
Fax Number :
Provider Business Practice Location Address
First Line : 1505 ORRIN RD
Second Line :
City : PRESCOTT
State : WI
Zip : 54021-1074
Country : US
Telephone Number : 715-262-5661
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2014
Last Update Date : 10/21/2014

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Directions to “ KAELEIGH ADAMI DPT” Practice Location

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