MEDICARE: WILLIAMS PHYSICAL THERAPY, INC

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	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922769355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAMS PHYSICAL THERAPY, INC

Provider Business Mailing Address
First Line	:	PO BOX 17805
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30316-0805
Country	:	US
Telephone Number	:	404-428-8071
Fax Number	:

Provider Business Practice Location Address
First Line	:	416 HOOPER ST SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30317-3417
Country	:	US
Telephone Number	:	404-428-8071
Fax Number	:

Authorized Official
Title or Position	:	OWNER, PT
Name	:	AMY WILLIAMS
Credential	:	MPT
Telephone Number	:	404-428-8071

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	01/07/2022

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