Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | 8266 | AZ |
Y | 111NS0005X | Chiropractic Sports Physician | 8266 | AZ |
NPI | 1205180684 |
---|---|
Provider Name | Dr. Natasha Williams |
First Address | Phoenix, AZ 85020-2819 |
Second Address | Phoenix, AZ 85020-2819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2012 |
Last Update Date | 01/12/2016 |