Provider Demographics
NPI:1265463012
Name:ADAMS, LYNN GEORGE (PT)
Entity Type:Individual
Prefix:MR
First Name:LYNN
Middle Name:GEORGE
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 S 500 W
Mailing Address - Street 2:
Mailing Address - City:PAYSON
Mailing Address - State:UT
Mailing Address - Zip Code:84651-3201
Mailing Address - Country:US
Mailing Address - Phone:801-465-7979
Mailing Address - Fax:801-465-7980
Practice Address - Street 1:867 S 500 W
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:UT
Practice Address - Zip Code:84651-3201
Practice Address - Country:US
Practice Address - Phone:801-465-7979
Practice Address - Fax:801-465-7980
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT120450-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTPRA04380Medicaid
UTQM0000076279OtherALTIUS
UTPRA04380Medicaid