Individual
ADAM WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
871 PACER DR NW, CORYDON, IN 47112-2145
(812) 738-0317
Mailing address
6437 HIGHWAY 62, LANESVILLE, IN 47136-9438
(812) 225-1967
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005114A
IN
Other
Enumeration date
12/09/2016
Last updated
12/09/2016
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