Provider Demographics
NPI:1356570295
Name:LONG, ADAM DAVID (DPT)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:DAVID
Last Name:LONG
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:3466 PINE RIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-3883
Mailing Address - Country:US
Mailing Address - Phone:239-261-2663
Mailing Address - Fax:239-262-5633
Practice Address - Street 1:3466 PINE RIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-3883
Practice Address - Country:US
Practice Address - Phone:239-261-2663
Practice Address - Fax:239-262-5633
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2022-09-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPT34578225100000X
PAPT020061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty