Provider Demographics
NPI:1518421171
Name:ADAMS, LIN (OTR)
Entity Type:Individual
Prefix:
First Name:LIN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:LIN
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 MIDDLETON LN
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-3347
Mailing Address - Country:US
Mailing Address - Phone:706-308-9890
Mailing Address - Fax:
Practice Address - Street 1:2750 ATLANTA HWY
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3366
Practice Address - Country:US
Practice Address - Phone:706-521-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.012857225X00000X
GAOT007734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist