Provider Demographics
NPI:1598287666
Name:ADKINS, RICKER STANTON (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:RICKER
Middle Name:STANTON
Last Name:ADKINS
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BROAD ST RM 106
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121-3302
Mailing Address - Country:US
Mailing Address - Phone:215-204-2146
Mailing Address - Fax:215-204-2133
Practice Address - Street 1:1800 N BROAD ST RM 106
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121-3302
Practice Address - Country:US
Practice Address - Phone:215-204-2146
Practice Address - Fax:215-204-2133
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0057462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer