Provider Demographics
NPI:1285792416
Name:DUIS, ADAM JOHN (ATC)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:JOHN
Last Name:DUIS
Suffix:
Gender:M
Credentials:ATC
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Mailing Address - Street 1:524 N DECATUR LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5957
Mailing Address - Country:US
Mailing Address - Phone:404-457-8527
Mailing Address - Fax:404-299-1616
Practice Address - Street 1:1014 SYCAMORE DR # B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1644
Practice Address - Country:US
Practice Address - Phone:404-299-1700
Practice Address - Fax:404-299-1616
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAT0011172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer