MEDICARE: PEGGY MCWILLIAMS

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

General Provider Information

NPI Number	:	1811354517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY MCWILLIAMS

Provider Business Mailing Address
First Line	:	16999 GREEN CREST LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40245-3217
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2632 GRANT LINE RD
Second Line	:
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-4000
Country	:	US
Telephone Number	:	812-944-9048
Fax Number	:

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	10/01/2019

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Directions to “ PEGGY MCWILLIAMS ” Practice Location

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