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NPI Code Detail

MEDICARE: MRS. LORI ANNE WILLIAMSON PT

MEDICARE: MRS. LORI ANNE WILLIAMSON PT
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
1225100000XPhysical Therapist1098671TX

General Provider Information

NPI Number : 1215273669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORI ANNE WILLIAMSON PT
Provider Business Mailing Address
First Line : 8632 TANGLERIDGE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76123-4019
Country : US
Telephone Number : 817-944-2231
Fax Number :
Provider Business Practice Location Address
First Line : 3201 RIVER PARK DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-9533
Country : US
Telephone Number : 817-386-8531
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2012
Last Update Date : 12/12/2012

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Directions to “ MRS. LORI ANNE WILLIAMSON PT” Practice Location

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