Provider Demographics
NPI:1518274737
Name:VERNON, ADRIAN ALAN (OTR)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:ALAN
Last Name:VERNON
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 W 17TH ST
Mailing Address - Street 2:APT 7C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5363
Mailing Address - Country:US
Mailing Address - Phone:347-839-5267
Mailing Address - Fax:
Practice Address - Street 1:3000 NORTHWOODS PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4708
Practice Address - Country:US
Practice Address - Phone:704-887-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation