Healthcare Provider Details

I. General information

NPI: 1801005699
Provider Name (Legal Business Name): MARLON S WILLIAMS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAY 12 RR1 THE VILLAGE MALL
KINGSHILL VI
00850-9604
US

IV. Provider business mailing address

BOX 10556 RR1 THE VILLAGE MALL BAY 12
KINGSHILL ST CROIX VI
00850-9604
US

V. Phone/Fax

Practice location:
  • Phone: 340-773-4300
  • Fax: 340-773-4300
Mailing address:
  • Phone: 340-773-4300
  • Fax: 340-773-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9C
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: