MEDICARE: DR. TERRY L WILLIAMS JR. DC

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	111N00000X	Chiropractor	1717	AR
2	111N00000X	Chiropractor	2304	AL
3	111N00000X	Chiropractor	2008005857	MO

General Provider Information

NPI Number	:	1134312788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY L WILLIAMS JR. DC

Provider Business Mailing Address
First Line	:	7700 CLAYTON RD
Second Line	:	SUITE 305
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1328
Country	:	US
Telephone Number	:	479-200-3134
Fax Number	:

Provider Business Practice Location Address
First Line	:	7700 CLAYTON RD
Second Line	:	SUITE 305
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1328
Country	:	US
Telephone Number	:	479-200-3134
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	09/24/2012

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