Healthcare Provider Details

I. General information

NPI: 1750544789
Provider Name (Legal Business Name): AMY MARIE WILLIAMS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 W 213TH ST SUITE 100
TORRANCE CA
90501-2800
US

IV. Provider business mailing address

1815 W 213TH ST SUITE 100
TORRANCE CA
90501-2800
US

V. Phone/Fax

Practice location:
  • Phone: 310-328-0276
  • Fax:
Mailing address:
  • Phone: 310-328-0276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number32923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: