Provider Demographics
NPI:1780297481
Name:ADAMS, HEATHER LORIN (PT, DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:LORIN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LORIN
Other - Last Name:LAPRADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:3626 CANYON SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-0345
Mailing Address - Country:US
Mailing Address - Phone:404-704-2314
Mailing Address - Fax:
Practice Address - Street 1:104 BUILDERS PKWY
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-5396
Practice Address - Country:US
Practice Address - Phone:678-616-3099
Practice Address - Fax:770-406-6840
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT014887225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty