Provider Demographics
NPI:1134475486
Name:SHILLING, ADAM D (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:D
Last Name:SHILLING
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30085 COMERCIO
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-2106
Mailing Address - Country:US
Mailing Address - Phone:949-766-8535
Mailing Address - Fax:949-766-8540
Practice Address - Street 1:30085 COMERCIO
Practice Address - Street 2:
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688-2106
Practice Address - Country:US
Practice Address - Phone:949-766-8535
Practice Address - Fax:949-766-8540
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39199225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist