Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR010046 | GA |
NPI | 1063904340 |
---|---|
Provider Name | Rhonda Williams |
First Address | Smyrna, GA 30080-7655 |
Second Address | Morrow, GA 30260-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2018 |
Last Update Date | 03/06/2018 |