Provider Demographics
NPI:1033443239
Name:WILLIAMSON, DONALD (LPT)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 BLITZEN RD NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4670
Mailing Address - Country:US
Mailing Address - Phone:330-232-1113
Mailing Address - Fax:
Practice Address - Street 1:7442 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720
Practice Address - Country:US
Practice Address - Phone:330-305-0838
Practice Address - Fax:330-491-2049
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 12357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist