Jennifer Adams

Individual provider Active NPI Physical Therapy Assistant · Madison, WI

NPI 1619310679 · NPPES record last updated Apr 9, 2013

Key facts

NPI
1619310679
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
1702-19 (WI)
Practice address
4502 Milwaukee St
Madison, WI 53714-2133
Phone
(608) 249-2137
Fax
(608) 249-7622
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
160.005528ILMDPhysical Therapy Assistant
1702-19WIMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1702-19 WI Yes
Physical Therapy Assistant 225200000X 160.005528 IL

Addresses

Primary practice location

4502 Milwaukee St
Madison, WI 53714-2133

Mailing address

4502 Milwaukee St
Madison, WI 53714-2133
Phone (608) 249-2137

Other providers in Madison, WI

All providers in Madison, WI · Physical Therapy Assistant in Wisconsin

Sources for this page

Verify at the official NPI Registry.