Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 10598 | GA |
NPI | 1174281851 |
---|---|
Provider Name | Dr. Darian Williams |
First Address | Marietta, GA 30062-3682 |
Second Address | Atlanta, GA 30309-2439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |