Provider Demographics
NPI:1427689371
Name:ADAMS, RYAN JAMES
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:JAMES
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 JARVIS GORE DR
Mailing Address - Street 2:
Mailing Address - City:EDDINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04428-3414
Mailing Address - Country:US
Mailing Address - Phone:207-299-6902
Mailing Address - Fax:
Practice Address - Street 1:293 JARVIS GORE DR
Practice Address - Street 2:
Practice Address - City:EDDINGTON
Practice Address - State:ME
Practice Address - Zip Code:04428-3414
Practice Address - Country:US
Practice Address - Phone:207-299-6902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT3757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist