Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | PT02396 | RI |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT02396 | RI |
NPI | 1265445969 |
---|---|
Provider Name | Miss Julie Angela Williams |
First Address | Wakefield, RI 02879-3176 |
Second Address | Wakefield, RI 02879-3176 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 29/09/2016 |