Provider Demographics
NPI:1588016281
Name:CELLAMARE, ADAM (ATC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CELLAMARE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MEDICAL PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-2456
Mailing Address - Country:US
Mailing Address - Phone:864-797-9731
Mailing Address - Fax:
Practice Address - Street 1:315 MEDICAL PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2456
Practice Address - Country:US
Practice Address - Phone:864-797-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9052255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer