Healthcare Provider Details

I. General information

NPI: 1285830836
Provider Name (Legal Business Name): BONNIE L. WILLIAMSON D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 06/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43 PEARSON FALLS RD
SALUDA NC
28773-9772
US

IV. Provider business mailing address

43 PEARSON FALLS RD
SALUDA NC
28773-9772
US

V. Phone/Fax

Practice location:
  • Phone: 828-749-3875
  • Fax: 828-749-3876
Mailing address:
  • Phone: 828-749-3875
  • Fax: 828-749-3876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3143
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2749
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: