Provider Demographics
NPI:1780050641
Name:SMITH, ADAM (ATC)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:SMITH
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:23 WESTHAMPTON WAY
Mailing Address - Street 2:ROOM 163; ROBINS CENTER
Mailing Address - City:UNIVERSITY OF RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23173
Mailing Address - Country:US
Mailing Address - Phone:804-287-6523
Mailing Address - Fax:804-289-8791
Practice Address - Street 1:23 WESTHAMPTON WAY
Practice Address - Street 2:ROOM 163; ROBINS CENTER
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23173-0001
Practice Address - Country:US
Practice Address - Phone:804-287-6523
Practice Address - Fax:804-289-8791
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
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Provider Licenses
StateLicense IDTaxonomies
VA01260013812255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer