Healthcare Provider Details

I. General information

NPI: 1114025384
Provider Name (Legal Business Name): LINDA SUSAN WILLIAMS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12831 6TH ST UNIT C
LILLIAN AL
36549-4166
US

IV. Provider business mailing address

251 JOHNSTON ST SE SUITE 300
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 251-961-0090
  • Fax: 251-961-0092
Mailing address:
  • Phone: 256-340-9708
  • Fax: 256-340-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH7521
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: