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General NPI Number Information
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NPI Number | 1366888794
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Entity Type | Individual
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Provider Name | RYAN LLOYD WILLIAMS ATC, OTC
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Gender | Male
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 181 W MEADOW DR SUITE 200
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City | VAIL
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State | CO
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Zip | 81657-5242
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Country | US
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Telephone | 636-346-1683
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Fax |
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Provider Business Mailing Address
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Address Line | 654 STONE CREEK DRIVE #20 X1658
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City | AVON
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State | CO
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Zip | 81620-1658
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Country | US
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Telephone | 636-346-1683
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1101
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License Number State | CO
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