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Individual

KENDALL JAMES ADAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
720 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 552-5025
Mailing address
1560 S CAROL ST, MERIDIAN, ID 83646-1839
(208) 288-1155

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5392
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT5392
STATE LICENSE
ID
Enumeration date
02/13/2018
Last updated
02/13/2018
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  • EDI platform