Provider Demographics
NPI:1972640043
Name:ADAMS, KERRY H (CMT)
Entity type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:H
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:CHANGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07831-0026
Mailing Address - Country:US
Mailing Address - Phone:908-689-6140
Mailing Address - Fax:908-689-6156
Practice Address - Street 1:209 CHANGEWATER ROAD
Practice Address - Street 2:
Practice Address - City:CHANGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07831-0026
Practice Address - Country:US
Practice Address - Phone:908-689-6140
Practice Address - Fax:908-689-6156
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26BT00014300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist