Provider Demographics
NPI:1780959015
Name:ADAMS, AMY (PT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 CROWNE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:NEWBERN
Mailing Address - State:TN
Mailing Address - Zip Code:38059-5459
Mailing Address - Country:US
Mailing Address - Phone:731-697-3736
Mailing Address - Fax:
Practice Address - Street 1:2084 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3515
Practice Address - Country:US
Practice Address - Phone:731-686-8321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist