Provider Demographics
NPI:1669171906
Name:ADKINS, ANDREW (PTA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:ADKINS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 FORD ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-3304
Mailing Address - Country:US
Mailing Address - Phone:570-885-0194
Mailing Address - Fax:
Practice Address - Street 1:147 OLD NEWPORT ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-1327
Practice Address - Country:US
Practice Address - Phone:570-735-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant