Individual
MARK DAVID ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
500 W FORT ST, BOISE, ID 83702-4501
(208) 422-1000
Mailing address
4439 SE OGDEN ST, PORTLAND, OR 97206-8455
(503) 863-9786
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
03246
OR
Other
Enumeration date
04/15/2022
Last updated
04/15/2022
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