Provider Demographics
NPI:1104811389
Name:ADAMS, ANGELA D (PT)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:D
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:464 KY HIGHWAY 699
Mailing Address - Street 2:
Mailing Address - City:CORNETTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41731-8749
Mailing Address - Country:US
Mailing Address - Phone:606-476-2450
Mailing Address - Fax:606-476-2450
Practice Address - Street 1:464 KY HIGHWAY 699
Practice Address - Street 2:
Practice Address - City:CORNETTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41731-8749
Practice Address - Country:US
Practice Address - Phone:606-476-2450
Practice Address - Fax:606-476-2450
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0748801Medicare PIN
P79137Medicare UPIN