Provider Demographics
NPI:1548426307
Name:ADAMS, MARY ANN (PT)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 S BALSAM ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6700
Mailing Address - Country:US
Mailing Address - Phone:303-980-5500
Mailing Address - Fax:303-987-1185
Practice Address - Street 1:1805 S BALSAM ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6700
Practice Address - Country:US
Practice Address - Phone:303-980-5500
Practice Address - Fax:303-987-1185
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist