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General NPI Number Information
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NPI Number | 1124395579
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Entity Type | Individual
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Provider Name | TERESA ANN WILLIAMS P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/29/2011
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 150 MAIN ST SUITE 2
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City | FORT LUPTON
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State | CO
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Zip | 80621-1852
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Country | US
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Telephone | 303-857-1111
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Fax | 303-857-1198
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Provider Business Mailing Address
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Address Line | 2159 PINON CIR
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City | ERIE
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State | CO
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Zip | 80516-7958
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Country | US
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Telephone | 720-505-1752
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Fax | 303-857-1198
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11072
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License Number State | CO
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