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General NPI Number Information
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NPI Number | 1902064223
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Entity Type | Organization
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Legal Business Name | MICHAEL A. WILLIAMS, DC
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Dates
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Enumeration Date | 05/23/2008
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 8633 MEXICO RD
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City | O FALLON
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State | MO
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Zip | 63366-7506
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Country | US
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Telephone | 636-272-8888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 935
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City | O FALLON
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State | MO
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Zip | 63366-0935
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Country | US
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Telephone | 636-272-8888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL WILLIAMS
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Credential | D.C.
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Telephone | 636-272-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | CD-006167
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License Number State | MO
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