Healthcare Provider Details

I. General information

NPI: 1083816763
Provider Name (Legal Business Name): JOHN M WILLIAMS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

686 OLD DOVER ROAD
WESTERVILLE OH
43082-6464
US

IV. Provider business mailing address

686 OLD DOVER ROAD
WESTERVILLE OH
43082-6464
US

V. Phone/Fax

Practice location:
  • Phone: 614-891-7931
  • Fax:
Mailing address:
  • Phone: 614-891-7931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.001784
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT.001784
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: