Provider Demographics
NPI:1134779077
Name:ADAMS PERFORMANCE PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:ADAMS PERFORMANCE PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:757-329-6682
Mailing Address - Street 1:3004 IMPALA PL
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4206
Mailing Address - Country:US
Mailing Address - Phone:757-329-6682
Mailing Address - Fax:855-700-6837
Practice Address - Street 1:3004 IMPALA PL
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-4206
Practice Address - Country:US
Practice Address - Phone:757-329-6682
Practice Address - Fax:855-700-6837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty