Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 5571 | SC |
N | 225100000X | Physical Therapist | 9632 | CO |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT0000000 | FL |
NPI | 1053505586 |
---|---|
Provider Name | Adam Endress |
First Address | Jacksonville, FL 32216-8070 |
Second Address | Orange Park, FL 32073-5571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2007 |
Last Update Date | 25/03/2015 |