Provider Demographics
NPI:1679196612
Name:ADAMS, ANDREW D (DPT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:D
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 SW HIGGINS AVE STE 2051001
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1341
Mailing Address - Country:US
Mailing Address - Phone:406-721-3096
Mailing Address - Fax:406-721-3956
Practice Address - Street 1:1001 SW HIGGINS AVE STE 2051001
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1341
Practice Address - Country:US
Practice Address - Phone:406-721-3096
Practice Address - Fax:406-721-3956
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID6720225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist