Provider Demographics
NPI:1225682891
Name:WILLIAMS, ZACHARY FRANCIS (PTA)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:FRANCIS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1682 AUGUSTA SOLSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ORISKANY FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13425-4207
Mailing Address - Country:US
Mailing Address - Phone:315-244-6979
Mailing Address - Fax:
Practice Address - Street 1:159 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2045
Practice Address - Country:US
Practice Address - Phone:315-342-9575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012152225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant