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General NPI Number Information
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NPI Number | 1528570850
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Entity Type | Organization
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Legal Business Name | ELIZA WILLIAMS: RESTORATIVE BODY THERAPIES
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 3 REGENCY PLAZA SUITE 2
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City | PROVIDENCE
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State | RI
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Zip | 02903
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Country | US
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Telephone | 401-383-9989
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Fax |
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Provider Business Mailing Address
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Address Line | 3 REGENCY PLZ STE 2
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City | PROVIDENCE
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State | RI
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Zip | 02903-3123
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Country | US
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Telephone | 401-383-9989
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TAYLOR WILLIAMS
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Credential | LMT
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Telephone | 401-383-9989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 4525
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License Number State | MA
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