Provider Demographics
NPI:1851288021
Name:HARTSHORN, ADAM (DPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HARTSHORN
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 1:404 W 2230 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1576
Mailing Address - Country:US
Mailing Address - Phone:801-449-0253
Mailing Address - Fax:385-314-3411
Practice Address - Street 1:404 W 2230 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1576
Practice Address - Country:US
Practice Address - Phone:801-449-0253
Practice Address - Fax:385-314-3411
Is Sole Proprietor?:No
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12304476-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist