Provider Demographics
NPI:1982004966
Name:ADAMS, RACHAEL JORDYN (PTA)
Entity Type:Individual
Prefix:MISS
First Name:RACHAEL
Middle Name:JORDYN
Last Name:ADAMS
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 1:269 TURNER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:KY
Mailing Address - Zip Code:41040-8625
Mailing Address - Country:US
Mailing Address - Phone:859-391-7224
Mailing Address - Fax:
Practice Address - Street 1:269 TURNER RIDGE RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:KY
Practice Address - Zip Code:41040-8625
Practice Address - Country:US
Practice Address - Phone:859-391-7224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA03173225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant