Provider Demographics
NPI:1073748976
Name:TRITT, ADAM BYRN (LMT)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:BYRN
Last Name:TRITT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:990 DARWIN LN NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-5927
Mailing Address - Country:US
Mailing Address - Phone:321-961-5885
Mailing Address - Fax:321-676-3384
Practice Address - Street 1:1071 PORT MALABAR BLVD NE
Practice Address - Street 2:SUITE 106
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-5161
Practice Address - Country:US
Practice Address - Phone:321-676-3383
Practice Address - Fax:321-676-3384
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA54881225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist