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General NPI Number Information
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NPI Number | 1265972467
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Entity Type | Individual
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Provider Name | CHRISTOPHER RYAN WILLIAMS L.A.T.
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Gender | Male
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 1522 BEVERLY ST
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City | ODESSA
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State | TX
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Zip | 79761-2939
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Country | US
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Telephone | 432-528-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 1522 BEVERLY ST
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City | ODESSA
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State | TX
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Zip | 79761-2939
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Country | US
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Telephone | 432-528-9933
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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 | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | AT7047
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License Number State | TX
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