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NPI Code Detail

MEDICARE: ADAM ELLIOTT ANDERSON DPT

MEDICARE: ADAM ELLIOTT ANDERSON 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 Therapist7930MN
2225100000XPhysical Therapist070-016056IL

General Provider Information

NPI Number : 1750577524
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM ELLIOTT ANDERSON DPT
Provider Business Mailing Address
First Line : 33900 HARPER AVE STE 104
Second Line :
City : CLINTON TWP
State : MI
Zip : 48035-4258
Country : US
Telephone Number : 586-350-2644
Fax Number : 586-541-3735
Provider Business Practice Location Address
First Line : 1077 E GOLF RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4271
Country : US
Telephone Number : 847-305-1400
Fax Number : 847-305-1556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2007
Last Update Date : 04/29/2024

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Directions to “ ADAM ELLIOTT ANDERSON DPT” Practice Location

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