Provider Demographics
NPI:1235447707
Name:ADAMS, NOELLE PEARL (DPT)
Entity Type:Individual
Prefix:MISS
First Name:NOELLE
Middle Name:PEARL
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-4589
Mailing Address - Country:US
Mailing Address - Phone:304-218-1027
Mailing Address - Fax:
Practice Address - Street 1:15251 NATIONAL AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2400
Practice Address - Country:US
Practice Address - Phone:408-356-1990
Practice Address - Fax:408-356-4736
Is Sole Proprietor?:No
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 37030225100000X
WVPT 002797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist