Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 10-1219 | AZ |
NPI | 1093025553 |
---|---|
Provider Name | Dr. John D Williamson |
First Address | Tempe, AZ 85282-7519 |
Second Address | Tempe, AZ 85282-7519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 29/08/2012 |