MEDICARE: MARCI GOLDBERG WILLIAMSON PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT4470	FL

General Provider Information

NPI Number	:	1346480811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI GOLDBERG WILLIAMSON PT

Provider Business Mailing Address
First Line	:	2222 SULLIVAN TRL
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18040-7958
Country	:	US
Telephone Number	:	800-944-9782
Fax Number	:	610-438-2024

Provider Business Practice Location Address
First Line	:	203 S WEKIWA SPRINGS RD
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-4778
Country	:	US
Telephone Number	:	407-889-7704
Fax Number	:	407-889-3425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2009
Last Update Date	:	02/24/2009

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