=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578454658
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXIS WILLIAMS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2025
-----------------------------------------------------
Last Update Date | 07/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 31054 OH-93
-----------------------------------------------------
City | MCARTHUR
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45651
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-288-6816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 31460 MORGAN RD
-----------------------------------------------------
City | MC ARTHUR
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45651-8919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-288-6816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | PTA012937
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------