Provider Demographics
NPI:1275908857
Name:JAVATE, ADAM J (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:J
Last Name:JAVATE
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 1:10895 S EASTERN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-5852
Mailing Address - Country:US
Mailing Address - Phone:725-204-1016
Mailing Address - Fax:725-204-6572
Practice Address - Street 1:10895 S EASTERN AVE STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-5852
Practice Address - Country:US
Practice Address - Phone:725-204-1016
Practice Address - Fax:725-204-6572
Is Sole Proprietor?:No
Enumeration Date:2015-12-07
Last Update Date:2022-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433152251X0800X
NV4349225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic