Provider Demographics
NPI:1770971558
Name:ADAMS, AMI (MS, LAT, CES)
Entity type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MS, LAT, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103A REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-2951
Mailing Address - Country:US
Mailing Address - Phone:937-726-8072
Mailing Address - Fax:
Practice Address - Street 1:1886 UPPER MAPLE ST
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-1555
Practice Address - Country:US
Practice Address - Phone:860-412-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0006262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer