Provider Demographics
NPI:1154834554
Name:ADAMS, KURTIS GRANT (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:KURTIS
Middle Name:GRANT
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6508 FISHER HILL RD
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-9333
Mailing Address - Country:US
Mailing Address - Phone:585-474-4834
Mailing Address - Fax:
Practice Address - Street 1:6508 FISHER HILL RD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-9333
Practice Address - Country:US
Practice Address - Phone:585-474-4834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014666225100000X
WA60733725225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist