Provider Demographics
NPI:1134312788
Name:WILLIAMS, TERRY L JR (DC)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 CLAYTON RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1328
Mailing Address - Country:US
Mailing Address - Phone:479-200-3134
Mailing Address - Fax:
Practice Address - Street 1:7700 CLAYTON RD
Practice Address - Street 2:SUITE 305
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1328
Practice Address - Country:US
Practice Address - Phone:479-200-3134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-27
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1717111N00000X
AL2304111N00000X
MO2008005857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor