Provider Demographics
NPI:1467704056
Name:WILLIAMS, ERICA LYNN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37250 5 MILE RD
Mailing Address - Street 2:UNIT D1
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1848
Mailing Address - Country:US
Mailing Address - Phone:734-462-3240
Mailing Address - Fax:734-462-3831
Practice Address - Street 1:37250 5 MILE RD
Practice Address - Street 2:UNIT D1
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1848
Practice Address - Country:US
Practice Address - Phone:734-462-3240
Practice Address - Fax:734-462-3831
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist