Provider Demographics
NPI:1124906391
Name:ADAMS, AUSTIN DAMON
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:DAMON
Last Name:ADAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 KING COTTON LN
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-8099
Mailing Address - Country:US
Mailing Address - Phone:334-300-7120
Mailing Address - Fax:334-300-7120
Practice Address - Street 1:209 W SPRING ST STE 101
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2974
Practice Address - Country:US
Practice Address - Phone:334-300-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA10293225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant