Healthcare Provider Details

I. General information

NPI: 1609678499
Provider Name (Legal Business Name): NATHAN STEVEN WILLIAMS DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 2ND AVE
DETROIT MI
48202-3006
US

IV. Provider business mailing address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

V. Phone/Fax

Practice location:
  • Phone: 313-972-4140
  • Fax: 313-972-4140
Mailing address:
  • Phone: 734-416-3900
  • Fax: 734-453-2118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501303815
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: