Provider Demographics
NPI:1083609457
Name:WILLIAMS, ALYNE L (ATC, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:ALYNE
Middle Name:L
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10604 N FAYE AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-9476
Mailing Address - Country:US
Mailing Address - Phone:765-282-2372
Mailing Address - Fax:
Practice Address - Street 1:4201 S WASHINGTON ST
Practice Address - Street 2:INDIANA WESLEYAN UNIVERSITY
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4974
Practice Address - Country:US
Practice Address - Phone:765-677-1673
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36000384A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer