Provider Demographics
NPI:1245367473
Name:ADAMS, BRIAN J (PT, DPT, OCS, CSCS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PT, DPT, OCS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:46001 GRAND RIVER AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1319
Mailing Address - Country:US
Mailing Address - Phone:248-513-3003
Mailing Address - Fax:248-513-3004
Practice Address - Street 1:46001 GRAND RIVER AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1319
Practice Address - Country:US
Practice Address - Phone:248-513-3003
Practice Address - Fax:248-513-3004
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010101142251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic