Provider Demographics
NPI:1194835611
Name:WILLIAMS, EMILY (MPT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:873 SADDLEBRED WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7413
Mailing Address - Country:US
Mailing Address - Phone:770-364-9199
Mailing Address - Fax:
Practice Address - Street 1:1750 FOUNDERS PARKWAY
Practice Address - Street 2:SUITE 150
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3707
Practice Address - Country:US
Practice Address - Phone:678-624-9117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPT008119OtherLICENSE #