MEDICARE: WILLIAMS FAMILY CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NR0400X	Rehabilitation Chiropractor	1506	TN

General Provider Information

NPI Number	:	1053649384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS FAMILY CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	PO BOX 172112
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38187-2112
Country	:	US
Telephone Number	:	901-240-1861
Fax Number	:

Provider Business Practice Location Address
First Line	:	2039 MUNSON RD
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38134-6701
Country	:	US
Telephone Number	:	901-240-1861
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERSKINE A WILLIAMS
Credential	:	D.C.
Telephone Number	:	901-240-1861

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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