Provider Demographics
NPI:1285918284
Name:WOLFE, ADAM D (DPT)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:D
Last Name:WOLFE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-1206
Mailing Address - Country:US
Mailing Address - Phone:570-524-4446
Mailing Address - Fax:570-522-1110
Practice Address - Street 1:900 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1206
Practice Address - Country:US
Practice Address - Phone:570-524-4446
Practice Address - Fax:570-522-1110
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT0207842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic