Doctor Name: | JASON WILLIAMS |
NPI Number: | 1588936363 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PTA, NSCA-CPT |
License Number: | 7173161008 |
Business Practice Address: | 4215 Landing Dr 2c Aurora, IL - 605045017 |
Business Phone Number: | 2246884040 |
Business Fax Number: | |
Mailing Address: | 4215 Landing Dr, 2c AURORA |
State: | IL |
Postal Code: | 605045017 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/08/2012 |
NPI Last Update Date: | 02/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 7173161008 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |