Provider Demographics
NPI:1982971925
Name:DAVID, ADAM (DPT)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:DAVID
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ROCKHILL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2300
Mailing Address - Country:US
Mailing Address - Phone:856-751-2140
Mailing Address - Fax:856-751-5110
Practice Address - Street 1:16 ROCKHILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2300
Practice Address - Country:US
Practice Address - Phone:856-751-2140
Practice Address - Fax:856-751-5110
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01426300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist