Provider Demographics
NPI:1184464083
Name:J. ADKINS OCCUPATIONAL THERAPY, LLC
Entity type:Organization
Organization Name:J. ADKINS OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:850-682-8388
Mailing Address - Street 1:4100 S FERDON BLVD STE A1
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32536-5287
Mailing Address - Country:US
Mailing Address - Phone:850-682-8388
Mailing Address - Fax:850-682-7463
Practice Address - Street 1:4100 S FERDON BLVD STE A1
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32536-5287
Practice Address - Country:US
Practice Address - Phone:850-682-8388
Practice Address - Fax:850-682-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty