Healthcare Provider Details

I. General information

NPI: 1053649384
Provider Name (Legal Business Name): WILLIAMS FAMILY CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 11/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 MUNSON RD
MEMPHIS TN
38134-6701
US

IV. Provider business mailing address

PO BOX 172112
MEMPHIS TN
38187-2112
US

V. Phone/Fax

Practice location:
  • Phone: 901-240-1861
  • Fax:
Mailing address:
  • Phone: 901-240-1861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number1506
License Number StateTN

VIII. Authorized Official

Name: DR. ERSKINE A WILLIAMS
Title or Position: OWNER
Credential: D.C.
Phone: 901-240-1861