Provider Demographics
NPI:1033448618
Name:ADAMS, JEROME JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:
Last Name:ADAMS
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4653
Mailing Address - Country:US
Mailing Address - Phone:810-620-8042
Mailing Address - Fax:810-620-8043
Practice Address - Street 1:4121 SHRESTNA DR.
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-460-0020
Practice Address - Fax:989-460-0021
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013272225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist