MEDICARE: HALEY WILLIAMS

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	225200000X	Physical Therapy Assistant	8605	TN

General Provider Information

NPI Number	:	1639036783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY WILLIAMS

Provider Business Mailing Address
First Line	:	200 SUNNYFIELD DR
Second Line	:
City	:	BLOUNTVILLE
State	:	TN
Zip	:	37617-3467
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3135 PEOPLES ST STE 404
Second Line	:
City	:	JOHNSON CITY
State	:	TN
Zip	:	37604-4138
Country	:	US
Telephone Number	:	423-454-1006
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “ HALEY WILLIAMS ” Practice Location

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