Provider Demographics
NPI:1184015463
Name:ADAMS, BENJAMIN J
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:781 FAR HILLS DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NEW FREEDOM
Mailing Address - State:PA
Mailing Address - Zip Code:17349-8447
Mailing Address - Country:US
Mailing Address - Phone:717-235-9890
Mailing Address - Fax:717-235-9894
Practice Address - Street 1:781 FAR HILLS DR
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW FREEDOM
Practice Address - State:PA
Practice Address - Zip Code:17349-8447
Practice Address - Country:US
Practice Address - Phone:717-235-9890
Practice Address - Fax:717-235-9894
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT024254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist