Adam Fetter

Individual provider Active NPI Physical Therapist · Larkspur, CA

NPI 1669951802 · NPPES record last updated Aug 8, 2018

Key facts

NPI
1669951802
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
Practice address
5 Bon Air Rd Ste 129
Larkspur, CA 94939-1139
Phone
(415) 924-8900
NPI assigned
Aug 8, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
225100000X Yes

Addresses

Primary practice location

5 Bon Air Rd Ste 129
Larkspur, CA 94939-1139

Mailing address

5 Bon Air Rd Ste 129
Larkspur, CA 94939-1139

Other providers in Larkspur, CA

All providers in Larkspur, CA · Physical Therapist in California

Sources for this page

Verify at the official NPI Registry.