Provider Demographics
NPI:1952736720
Name:RHODA, ADAM DAVID (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:DAVID
Last Name:RHODA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30516
Mailing Address - Street 2:DEPT 5300
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-8016
Mailing Address - Country:US
Mailing Address - Phone:616-262-2233
Mailing Address - Fax:
Practice Address - Street 1:1335 W. MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-1555
Practice Address - Country:US
Practice Address - Phone:616-888-3184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60326237225100000X
MI5501016017225100000X
MEPT4044225100000X
WI12192-24225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist