Healthcare Provider Details

I. General information

NPI: 1295607455
Provider Name (Legal Business Name): NICHOLAS DUANE WILLIAMS LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 EATON RAPIDS RD STE 100
LANSING MI
48911-6354
US

IV. Provider business mailing address

8686 HOLMES HWY
EATON RAPIDS MI
48827-9581
US

V. Phone/Fax

Practice location:
  • Phone: 517-887-7599
  • Fax:
Mailing address:
  • Phone: 917-371-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.018673
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501013052
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: