Provider Demographics
NPI:1194055954
Name:ADAMS, SHANNON HOLT (BSPT)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:HOLT
Last Name:ADAMS
Suffix:
Gender:F
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 SAINT JAMES DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6759
Mailing Address - Country:US
Mailing Address - Phone:615-504-3507
Mailing Address - Fax:
Practice Address - Street 1:2533 SAINT JAMES DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-6759
Practice Address - Country:US
Practice Address - Phone:615-504-3507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist