Provider Demographics
NPI:1093001935
Name:WILLIAMS, AUBREY (PT)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:KOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:396 EAGLE FEATHER LOOP
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-5090
Mailing Address - Country:US
Mailing Address - Phone:540-287-9572
Mailing Address - Fax:
Practice Address - Street 1:2935 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6811
Practice Address - Country:US
Practice Address - Phone:803-254-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11281225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist