Provider Demographics
NPI:1699045021
Name:COLDSNOW, ADAM NATHANIEL (LMT)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:NATHANIEL
Last Name:COLDSNOW
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4974 HIGBEE AVE NW
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2562
Mailing Address - Country:US
Mailing Address - Phone:330-771-0380
Mailing Address - Fax:
Practice Address - Street 1:4974 HIGBEE AVE NW
Practice Address - Street 2:SUITE 112
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2562
Practice Address - Country:US
Practice Address - Phone:330-771-0380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-02
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.018840-C-D172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist