Basic Information
| Provider Information | |||||||||
| NPI: | 1386051373 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | LEIGH ANN | ||||||||
| MiddleName: | |||||||||
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| Credential: | ATC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ADAMS | ||||||||
| OtherFirstName: | LEIGH ANN | ||||||||
| OtherMiddleName: | WIDENER | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | ATC | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 1936 | ||||||||
| Address2: | |||||||||
| City: | CHILHOWIE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243191936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766468609 | ||||||||
| FaxNumber: | 2767837786 | ||||||||
| Practice Location | |||||||||
| Address1: | 1209 SNIDER ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243544221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2767839752 | ||||||||
| FaxNumber: | 2767837786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2014 | ||||||||
| LastUpdateDate: | 07/22/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | 0126000192 | VA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.