Provider Demographics
NPI:1225176985
Name:ADAMS, SUSAN HUDSON (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:HUDSON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2372 EAGLE DR NE
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-9497
Mailing Address - Country:US
Mailing Address - Phone:828-459-9000
Mailing Address - Fax:
Practice Address - Street 1:2372 EAGLE DR NE
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-9497
Practice Address - Country:US
Practice Address - Phone:828-459-9000
Practice Address - Fax:828-459-7610
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3277225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0797BOtherBCBSNC
NC7210567Medicaid