Healthcare Provider Details

I. General information

NPI: 1740854223
Provider Name (Legal Business Name): TOD MICHAEL WILLIAMS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 03/19/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3157 ROBERT C. BYRD DR.
BECKLEY WV
25801
US

IV. Provider business mailing address

3157 ROBERT C. BYRD DR
BECKLEY WV
25801
US

V. Phone/Fax

Practice location:
  • Phone: 304-253-3489
  • Fax:
Mailing address:
  • Phone: 304-253-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number35050
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1084
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: