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NPI Code Detail

MEDICARE: ADAM NOLL DPT

MEDICARE: ADAM NOLL 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 Therapist11-06004KS

General Provider Information

NPI Number : 1760955967
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM NOLL DPT
Provider Business Mailing Address
First Line : 1423 ANTHONY MICHAEL DR
Second Line :
City : LAWRENCE
State : KS
Zip : 66049-3861
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1031 SW FLEMING CT
Second Line :
City : TOPEKA
State : KS
Zip : 66604-1851
Country : US
Telephone Number : 785-440-0500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2019
Last Update Date : 01/10/2019

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