Provider Demographics
NPI:1649691627
Name:ADAMS, WILLIAM MICHAEL (ATC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:ADAMS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 HILLSIDE RD
Mailing Address - Street 2:UNIT 3008
Mailing Address - City:STORRS
Mailing Address - State:CT
Mailing Address - Zip Code:06269-9093
Mailing Address - Country:US
Mailing Address - Phone:860-486-6520
Mailing Address - Fax:
Practice Address - Street 1:2110 HILLSIDE RD
Practice Address - Street 2:UNIT 3008
Practice Address - City:STORRS
Practice Address - State:CT
Practice Address - Zip Code:06269-9093
Practice Address - Country:US
Practice Address - Phone:860-486-6520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006472255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer