Provider Demographics
NPI:1528103116
Name:ADAMO, AMY T (MED, ATC, CSCS)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:T
Last Name:ADAMO
Suffix:
Gender:F
Credentials:MED, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DAVIS ST
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1304
Mailing Address - Country:US
Mailing Address - Phone:207-827-3524
Mailing Address - Fax:
Practice Address - Street 1:5747 MEMORIAL GYM
Practice Address - Street 2:UNIVERSITY OF MAINE
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04469-5747
Practice Address - Country:US
Practice Address - Phone:207-581-1046
Practice Address - Fax:207-581-4474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAT2502255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer