Provider Demographics
NPI:1003005976
Name:ADAMSON, JOHN DUSKY JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DUSKY
Last Name:ADAMSON
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26179 RESERVATION LANE
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-5762
Mailing Address - Country:US
Mailing Address - Phone:804-258-3950
Mailing Address - Fax:
Practice Address - Street 1:26179 RESERVATION LANE
Practice Address - Street 2:
Practice Address - City:RUTHER GLEN
Practice Address - State:VA
Practice Address - Zip Code:22546-5762
Practice Address - Country:US
Practice Address - Phone:804-258-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIPT-5590OtherPT LICENSE
VA2305206712OtherPT LICENSE