Melinda Adams

Individual provider Active NPI Physical Therapist · Russellville, AR

NPI 1891966347 · NPPES record last updated Mar 12, 2008

Key facts

NPI
1891966347
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT1907 (AR)
Practice address
1301 Russell Road
Russellville, AR 72801
Phone
(479) 967-2322
Fax
(479) 967-2876
NPI assigned
Mar 12, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AR

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20200114000506 AR Practitioner - Physical Therapist in Private Practice 1355776790

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
PT1907ARMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1907 AR Yes

Addresses

Primary practice location

1301 Russell Road
Russellville, AR 72801

Mailing address

PO Drawer 2109
Russellville, AR 72811

Other providers in Russellville, AR

All providers in Russellville, AR · Physical Therapist in Arkansas

Sources for this page

Verify at the official NPI Registry.