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General NPI Number Information
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NPI Number | 1790882132
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Entity Type | Individual
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Provider Name | MERCEDES WILLIAMSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 2201 GEORGIA ST SUITE B
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City | LOUISIANA
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State | MO
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Zip | 63353-2581
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Country | US
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Telephone | 573-754-5350
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Fax | 573-754-5227
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Provider Business Mailing Address
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Address Line | 2201 GEORGIA ST SUITE B
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City | LOUISIANA
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State | MO
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Zip | 63353-2581
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Country | US
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Telephone | 573-754-5350
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Fax | 573-754-5227
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 006681
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License Number State | MO
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