Provider Demographics
NPI:1700051596
Name:ADKINS, BARBARA (PTA)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-2837
Mailing Address - Country:US
Mailing Address - Phone:386-453-7093
Mailing Address - Fax:
Practice Address - Street 1:401 VENTURE DR STE C
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3475
Practice Address - Country:US
Practice Address - Phone:386-763-0084
Practice Address - Fax:386-763-0085
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA8802225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant