Provider Demographics
NPI:1043553597
Name:ADAMS SPORTS MEDICINE & PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:ADAMS SPORTS MEDICINE & PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, CSCS
Authorized Official - Phone:248-513-3003
Mailing Address - Street 1:46001 GRAND RIVER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1319
Mailing Address - Country:US
Mailing Address - Phone:248-513-3003
Mailing Address - Fax:248-513-3004
Practice Address - Street 1:46001 GRAND RIVER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1319
Practice Address - Country:US
Practice Address - Phone:248-513-3003
Practice Address - Fax:248-513-3004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty