Provider Demographics
NPI:1619393808
Name:ADAMS, JULIUS TYLER
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:TYLER
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 BROAD ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3062
Mailing Address - Country:US
Mailing Address - Phone:865-398-2253
Mailing Address - Fax:855-232-8604
Practice Address - Street 1:113 BROAD ST STE 1000
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3062
Practice Address - Country:US
Practice Address - Phone:865-398-2253
Practice Address - Fax:855-232-8604
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3035225200000X
GAPTA004475225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant