Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT013966 | GA |
NPI | 1023677580 |
---|---|
Provider Name | Dr. Jasmine C Williams |
First Address | Flowery Branch, GA 30542-3507 |
Second Address | Dacula, GA 30019-2265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 10/06/2019 |