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NPI Code Detail

MEDICARE: MICAH ADAMS DPT

MEDICARE:   MICAH  ADAMS  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 Therapist5025OK

General Provider Information

NPI Number : 1689042061
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICAH ADAMS DPT
Provider Business Mailing Address
First Line : PO BOX 746
Second Line :
City : HARRAH
State : OK
Zip : 73045-0746
Country : US
Telephone Number : 405-454-0010
Fax Number : 405-454-0030
Provider Business Practice Location Address
First Line : 5002 S ANDERSON RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73150-3808
Country : US
Telephone Number : 405-732-0500
Fax Number : 405-732-0550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2015
Last Update Date : 09/02/2015

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Directions to “ MICAH ADAMS DPT” Practice Location

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