Provider Demographics
NPI:1467614719
Name:WILLIAMS, CHAD STEVEN (PT)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:STEVEN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 BASELINE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2366
Mailing Address - Country:US
Mailing Address - Phone:303-444-2951
Mailing Address - Fax:303-444-4779
Practice Address - Street 1:2935 BASELINE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2366
Practice Address - Country:US
Practice Address - Phone:303-444-2951
Practice Address - Fax:303-444-4779
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist