Provider Demographics
NPI:1891769733
Name:GREENFIELD, ADAM MARC (ATC/L)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:MARC
Last Name:GREENFIELD
Suffix:
Gender:M
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21407 PAGOSA CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1402
Mailing Address - Country:US
Mailing Address - Phone:954-592-4723
Mailing Address - Fax:561-417-5670
Practice Address - Street 1:21407 PAGOSA CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1402
Practice Address - Country:US
Practice Address - Phone:954-592-4723
Practice Address - Fax:561-417-5670
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL15692255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer