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NPI 1104974690

NPI 1104974690 : CHRISTINA FOSTER WILLIAMS LPTA : RIDGELAND, MS

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General NPI Number Information
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    NPI Number           |    1104974690
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTINA FOSTER WILLIAMS LPTA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/08/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    410 ORCHARD PARK 
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    City                 |    RIDGELAND
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    State                |    MS
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    Zip                  |    39157
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    Country              |    US
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    Telephone            |    601-956-1434
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    Fax                  |    601-956-4446
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Provider Business Mailing Address
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    Address Line         |    222 BOXWOOD CIR 
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    City                 |    BRANDON
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    State                |    MS
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    Zip                  |    39047
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    Country              |    US
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    Telephone            |    601-941-9326
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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        |    225200000X
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    Taxonomy Name        |    Physical Therapy Assistant
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    License Number       |    PTA3543
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    License Number State |    MS
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