Provider Demographics
NPI:1578603379
Name:ADAMS, PAULA TERESE (DC)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:TERESE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:KOLTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1383 21ST AVE N
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102
Mailing Address - Country:US
Mailing Address - Phone:701-365-0999
Mailing Address - Fax:701-298-3738
Practice Address - Street 1:1383 21ST AVE N
Practice Address - Street 2:SUITE A
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102
Practice Address - Country:US
Practice Address - Phone:701-365-0999
Practice Address - Fax:701-298-3738
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3820111N00000X
ND958111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor