Healthcare Provider Details

I. General information

NPI: 1245438464
Provider Name (Legal Business Name): ROBYN DIANE WILLIAMS DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7162 RENNER RD
SHAWNEE KS
66217-9409
US

IV. Provider business mailing address

17134 BEL RAY PL
BELTON MO
64012-5331
US

V. Phone/Fax

Practice location:
  • Phone: 913-962-7770
  • Fax: 913-962-7775
Mailing address:
  • Phone: 816-554-9559
  • Fax: 816-524-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11-03734
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: