Provider Demographics
NPI:1275814022
Name:WILLIAMS PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:WILLIAMS PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARMEN
Authorized Official - Middle Name:MCVOY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:805-672-2801
Mailing Address - Street 1:970 PETIT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2215
Mailing Address - Country:US
Mailing Address - Phone:805-672-2801
Mailing Address - Fax:
Practice Address - Street 1:970 PETIT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-2215
Practice Address - Country:US
Practice Address - Phone:805-672-2801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT009392261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1427121201OtherINDIVIDUAL NPI