Provider Demographics
NPI:1639691819
Name:ADAMS, WILLIAM (DPT)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12703 LAKE WILDERNESS LN
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22551-8122
Mailing Address - Country:US
Mailing Address - Phone:541-916-2914
Mailing Address - Fax:
Practice Address - Street 1:402 SE G ST
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-3066
Practice Address - Country:US
Practice Address - Phone:541-476-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR62324225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist