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NPI 1831119650

NPI 1831119650 : PATRICK WILLIAMS P.T. : CAPITOLA, CA

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General NPI Number Information
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    NPI Number           |    1831119650
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICK WILLIAMS P.T.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/21/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    824 BAY AVE 60
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    City                 |    CAPITOLA
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    State                |    CA
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    Zip                  |    95010-2104
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    Country              |    US
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    Telephone            |    831-475-0192
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    Fax                  |    831-475-1303
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Provider Business Mailing Address
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    Address Line         |    334 RIVERVIEW AVE 
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    City                 |    CAPITOLA
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    State                |    CA
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    Zip                  |    95010-3235
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    Country              |    US
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    Telephone            |    
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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       |    25885
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    License Number State |    CA
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