Individual
ADAM WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1925 VAUGHN RD NW, KENNESAW, GA 30144
(843) 992-4707
Mailing address
1504 KINGDOM WAY, INDIAN LAND, SC 29707-7757
(843) 992-4707
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
SC
Other
Enumeration date
05/30/2018
Last updated
06/14/2018
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