Basic Information
| Provider Information | |||||||||
| NPI: | 1033448618 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | JEROME | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.P.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 MILLER RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485034653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8106208042 | ||||||||
| FaxNumber: | 8106208043 | ||||||||
| Practice Location | |||||||||
| Address1: | 4121 SHRESTNA DR. | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894600020 | ||||||||
| FaxNumber: | 9894600021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2009 | ||||||||
| LastUpdateDate: | 05/25/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501013272 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.