Provider Demographics
NPI:1144540147
Name:ADAMS, TARYN S (PT)
Entity type:Individual
Prefix:MRS
First Name:TARYN
Middle Name:S
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:HAVANA
Mailing Address - State:FL
Mailing Address - Zip Code:32333-1217
Mailing Address - Country:US
Mailing Address - Phone:850-210-6691
Mailing Address - Fax:
Practice Address - Street 1:1915 WELBY WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4594
Practice Address - Country:US
Practice Address - Phone:850-325-6301
Practice Address - Fax:850-325-6302
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT21691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist