Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 104015 | MO |
Y | 2251N0400X | Physical Therapist - Neurology | 5242 | CO |
NPI | 1326253741 |
---|---|
Provider Name | Jan Harting Williams |
First Address | Lakewood, CO 80228-5311 |
Second Address | Centennial, CO 80111-1732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 14/12/2011 |