MEDICARE: GARTH WILLIAMS

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	172M00000X	Mechanotherapist	MA50011	FL

General Provider Information

NPI Number	:	1689996175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARTH WILLIAMS

Provider Business Mailing Address
First Line	:	4010 W HORATIO ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3939
Country	:	US
Telephone Number	:	813-857-1639
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 W SWANN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4023
Country	:	US
Telephone Number	:	813-857-1639
Fax Number	:

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

Provider Enumeration Date	:	02/24/2010
Last Update Date	:	02/24/2010

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Directions to “ GARTH WILLIAMS ” Practice Location

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