Healthcare Provider Details

I. General information

NPI: 1528038239
Provider Name (Legal Business Name): MATTHEW A WILLIAMS PT DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 MAIN ST STEP BY STEP PHYSICAL THERAPY
AKRON NY
14001
US

IV. Provider business mailing address

2333 N MAIN ST PO BOX 412
WARSAW NY
14569
US

V. Phone/Fax

Practice location:
  • Phone: 716-542-1135
  • Fax: 716-542-9931
Mailing address:
  • Phone: 585-786-8700
  • Fax: 585-786-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number023362
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: