Provider Demographics
NPI:1710269790
Name:BRIDGES, ADAM DALE (PT, MPT)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:DALE
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 BOWMAN DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28785-6115
Mailing Address - Country:US
Mailing Address - Phone:828-452-1306
Mailing Address - Fax:828-452-9058
Practice Address - Street 1:43 BOWMAN DR
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28785-6115
Practice Address - Country:US
Practice Address - Phone:828-452-1306
Practice Address - Fax:828-452-9058
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP133472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic