Provider Demographics
NPI:1508908823
Name:ADAMS, JODI ROCHELLE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:JODI
Middle Name:ROCHELLE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 FARMDALE RD
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-1330
Mailing Address - Country:US
Mailing Address - Phone:304-654-4863
Mailing Address - Fax:
Practice Address - Street 1:6475 FARNDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504
Practice Address - Country:US
Practice Address - Phone:304-733-6333
Practice Address - Fax:304-733-6388
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20062203225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist