Healthcare Provider Details

I. General information

NPI: 1023168853
Provider Name (Legal Business Name): HARRY MCWILLIAMS JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 N. CLAYTON ST.
CENTERBURG OH
43011-0039
US

IV. Provider business mailing address

PO BOX 39
CENTERBURG OH
43011-0039
US

V. Phone/Fax

Practice location:
  • Phone: 740-625-6212
  • Fax: 740-625-6217
Mailing address:
  • Phone: 740-625-6212
  • Fax: 740-625-6217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3362
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: