Provider Demographics
NPI:1811081896
Name:COPE, ADAM M (MPT)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:M
Last Name:COPE
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
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Mailing Address - Street 1:2176 E FRANKLIN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-9024
Mailing Address - Country:US
Mailing Address - Phone:208-288-1155
Mailing Address - Fax:208-288-0424
Practice Address - Street 1:2176 E FRANKLIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-9024
Practice Address - Country:US
Practice Address - Phone:208-288-1155
Practice Address - Fax:208-288-0424
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDMPT-1768174400000X
IDPT-1768225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1654594Medicare PIN