Provider Demographics
NPI:1285713677
Name:ADAMS, JANIS ELLEN (PT)
Entity type:Individual
Prefix:
First Name:JANIS
Middle Name:ELLEN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 EDWARD DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-8555
Mailing Address - Country:US
Mailing Address - Phone:770-957-3433
Mailing Address - Fax:770-957-9755
Practice Address - Street 1:1103 EDWARD DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-8555
Practice Address - Country:US
Practice Address - Phone:770-957-3433
Practice Address - Fax:770-957-9755
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0048182251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics