Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT.001784 | OH |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT.001784 | OH |
NPI | 1083816763 |
---|---|
Provider Name | Dr. John M Williams |
First Address | Westerville, OH 43082-6464 |
Second Address | Westerville, OH 43082-6464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2007 |
Last Update Date | 18/07/2007 |