Individual
MR. ROY ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, FMSK
Contact information
Practice address
111 W NORTH ST, PORTLAND, IN 47371-1153
(260) 726-6828
(260) 726-2257
Mailing address
PO BOX 1085, PORTLAND, IN 47371-3185
(260) 726-6828
(260) 726-2257
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05001458A
IN
225100000X
Physical Therapist
7774
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000105382
ANTHEM BLUE CROSS & BLUE SHIELD
IN
05
—
200154330
—
IN
Enumeration date
12/07/2005
Last updated
10/04/2021
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