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General NPI Number Information
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NPI Number | 1124373311
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Entity Type | Organization
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Legal Business Name | WILLIAMS CHIROPRACTIC
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 518 SE WASHINGTON BLVD STE B
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8236
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Country | US
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Telephone | 918-213-0550
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Fax | 877-518-0435
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Provider Business Mailing Address
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Address Line | 518 B SE WASHINGTON BLVD.
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City | BARTLESVILLE
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State | OK
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Zip | 74006
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Country | US
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Telephone | 918-213-0550
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Fax | 877-518-0435
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. JEREMIAH B WILLIAMS
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Credential | D.C.
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Telephone | 816-255-4992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4055
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License Number State | OK
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