Provider Demographics
NPI:1487743613
Name:ADAMS, DANIEL J (MPT)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 W. SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360
Mailing Address - Country:US
Mailing Address - Phone:856-696-5656
Mailing Address - Fax:856-696-0580
Practice Address - Street 1:1051 W. SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-696-5656
Practice Address - Fax:856-696-0580
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQA01219800225100000X
NJ40QA01219800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist