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General NPI Number Information
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NPI Number | 1710299979
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Entity Type | Individual
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Provider Name | VIRGINIA ELIZABETH WILLIAMS M.ED, ATC-L
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Gender | Female
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Dates
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Enumeration Date | 07/05/2010
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 115 S SAINT MARYS ST
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City | RALEIGH
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State | NC
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Zip | 27603-1699
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Country | US
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Telephone | 180-036-2090
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Fax | 186-643-4509
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Provider Business Mailing Address
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Address Line | 115 S SAINT MARYS ST
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City | RALEIGH
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State | NC
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Zip | 27603-1699
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Country | US
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Telephone | 180-036-2090
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Fax | 186-643-4509
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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 | 1430
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License Number State | NC
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