Healthcare Provider Details

I. General information

NPI: 1831672005
Provider Name (Legal Business Name): ALLISON TAYLOR WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 W CENTRAL AVE
DELAWARE OH
43015-1740
US

IV. Provider business mailing address

363 RICHLAND AVE APT 365
ATHENS OH
45701-3285
US

V. Phone/Fax

Practice location:
  • Phone: 740-513-8370
  • Fax:
Mailing address:
  • Phone: 740-341-1420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: