Provider Demographics
NPI:1285139444
Name:ADAM'S THERAPY SERVICES PLLC
Entity type:Organization
Organization Name:ADAM'S THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:MYATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-305-5104
Mailing Address - Street 1:3002 WESTWARD DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75964-1207
Mailing Address - Country:US
Mailing Address - Phone:936-305-5104
Mailing Address - Fax:
Practice Address - Street 1:3002 WESTWARD DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75964-1207
Practice Address - Country:US
Practice Address - Phone:936-305-5104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty