Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 40QA01722500 | NJ |
NPI | 1235666074 |
---|---|
Provider Name | Todd E Williams |
First Address | West Orange, NJ 07052-1424 |
Second Address | West Orange, NJ 07052-1424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2017 |
Last Update Date | 11/05/2017 |