| Doctor Name: | MR. MICHAEL ANDREW WILLIAMS |
| NPI Number: | 1801276415 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | PT-4212 |
| Business Practice Address: | 740 Mckinley Ave Kellogg, ID - 838372693 |
| Business Phone Number: | 2087833015 |
| Business Fax Number: | |
| Mailing Address: | 740 Mckinley Ave, KELLOGG |
| State: | ID |
| Postal Code: | 838372693 |
| Phone Number: | 2087833015 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2015 |
| NPI Last Update Date: | 06/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | PT-4212 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |