Healthcare Provider Details

I. General information

NPI: 1184432445
Provider Name (Legal Business Name): NOAH WILLIAMS LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3657 MORNING MEADOW LN
ORANGE PARK FL
32073-7602
US

IV. Provider business mailing address

3657 MORNING MEADOW LN
ORANGE PARK FL
32073-7602
US

V. Phone/Fax

Practice location:
  • Phone: 904-703-0304
  • Fax:
Mailing address:
  • Phone: 904-703-0304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA106218
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: