Individual
MRS. JESSICA HUMBACH ADAMCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, ATC
Contact information
Practice address
8918 BLAKENEY PROFESSIONAL DR, SUITE 120, CHARLOTTE, NC 28277-6691
(704) 900-8960
Mailing address
3113 CRESCENT KNOLL DR, MATTHEWS, NC 28105-2457
(847) 899-8037
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
P13724
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q40350A
MEDICARE PTAN
NC
Enumeration date
07/09/2012
Last updated
11/05/2015
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