Provider Demographics
NPI:1083160691
Name:HAMMER, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HAMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 LAS TABLAS RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-5603
Mailing Address - Country:US
Mailing Address - Phone:805-434-4885
Mailing Address - Fax:805-434-2864
Practice Address - Street 1:590 WAKARA WAY
Practice Address - Street 2:UUHC ORTHOPAEDIC CENTER - THERAPY SERVICES
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108
Practice Address - Country:US
Practice Address - Phone:801-587-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9832507-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist