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General NPI Number Information
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NPI Number | 1720800253
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Entity Type | Individual
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Provider Name | JONELL WILLIAMS PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 1301 SAINT JOHNS AVE
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City | PALATKA
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State | FL
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Zip | 32177-4539
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Country | US
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Telephone | 386-546-3379
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Fax |
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Provider Business Mailing Address
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Address Line | 1709 HUSSON AVE
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City | PALATKA
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State | FL
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Zip | 32177-5809
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Country | US
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Telephone | 386-336-2543
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT41426
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License Number State | FL
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