Stacey Nicole Adams, PTA

Individual provider Active NPI Physical Therapy Assistant · Palm Coast, FL

NPI 1679831697 · NPPES record last updated Apr 27, 2012

Key facts

NPI
1679831697
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA20044 (FL)
Practice address
2 Bowman PL
Palm Coast, FL 32137-8505
Phone
(386) 283-0103
NPI assigned
Apr 27, 2012
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
PTA20044FLMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA20044 FL Yes

Addresses

Primary practice location

2 Bowman PL
Palm Coast, FL 32137-8505

Mailing address

2 Bowman PL
Palm Coast, FL 32137-8505
Phone (386) 283-0103

Other providers in Palm Coast, FL

All providers in Palm Coast, FL · Physical Therapy Assistant in Florida

Sources for this page

Verify at the official NPI Registry.