MEDICARE: DR. VINCENT DEAN WILLIAMS D.C.

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	CHIROO7472	GA

General Provider Information

NPI Number	:	1285891499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT DEAN WILLIAMS D.C.

Provider Business Mailing Address
First Line	:	1000 WYNGATE PKWY STE 200
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6983
Country	:	US
Telephone Number	:	770-592-1877
Fax Number	:	770-592-1876

Provider Business Practice Location Address
First Line	:	1000 WYNGATE PKWY STE 200
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6983
Country	:	US
Telephone Number	:	770-592-1877
Fax Number	:	770-592-1876

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

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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