MEDICARE: CHRISTINA WILLIAMS CA

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	1744P3200X	Prosthetics Case Management		MO

General Provider Information

NPI Number	:	1144694548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA WILLIAMS CA

Provider Business Mailing Address
First Line	:	809 W 39TH ST # 160
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-7016
Country	:	US
Telephone Number	:	657-205-7674
Fax Number	:

Provider Business Practice Location Address
First Line	:	809 W 39TH ST # 160
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-7016
Country	:	US
Telephone Number	:	657-205-7674
Fax Number	:

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

Provider Enumeration Date	:	11/23/2015
Last Update Date	:	11/23/2015

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