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General NPI Number Information
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NPI Number | 1063904340
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Entity Type | Individual
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Provider Name | RHONDA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2018
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Last Update Date | 06/03/2018
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Provider Practice Location Address
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Address Line | 1544 SOUTHLAKE PKWY STE 9D
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City | MORROW
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State | GA
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Zip | 30260-3025
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Country | US
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Telephone | 470-868-0696
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Fax |
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Provider Business Mailing Address
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Address Line | 2089 LAKE PARK DR SE APT M
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City | SMYRNA
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State | GA
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Zip | 30080-7655
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | CHIR010046
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License Number State | GA
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