Basic Information
| Provider Information | |||||||||
| NPI: | 1760416887 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3994 DAISY CT | ||||||||
| Address2: | |||||||||
| City: | MONROVIA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217708919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018652115 | ||||||||
| FaxNumber: | 3018652117 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 E CHURCH ST STE 2 | ||||||||
| Address2: | |||||||||
| City: | FREDERICK | ||||||||
| State: | MD | ||||||||
| PostalCode: | 217015705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2405663568 | ||||||||
| FaxNumber: | 3178843388 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/07/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 20994 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.