Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 023988-1 | NY |
NPI | 1003027566 |
---|---|
Provider Name | Trisha Suzanne Williams |
First Address | Horseheads, NY 14845-8301 |
Second Address | Horseheads, NY 14845-8301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 20/07/2011 |