Provider Demographics
NPI:1952601742
Name:STORY, ADAM (PT, DPT, OTR/L, OTD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:
Last Name:STORY
Suffix:
Gender:M
Credentials:PT, DPT, OTR/L, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8334 E VIA DE LA ESCUELA
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3203
Mailing Address - Country:US
Mailing Address - Phone:480-298-2213
Mailing Address - Fax:
Practice Address - Street 1:8334 E VIA DE LA ESCUELA
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3203
Practice Address - Country:US
Practice Address - Phone:480-298-2213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9047225100000X, 225100000X
AZ4607225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ176953Medicare PIN