Provider Demographics
NPI:1477296275
Name:WILLIAMS, SYDNEY C (LPTA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:C
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 WEAVER AVE
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23847-1248
Mailing Address - Country:US
Mailing Address - Phone:434-336-5300
Mailing Address - Fax:434-336-5301
Practice Address - Street 1:219 WEAVER AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:VA
Practice Address - Zip Code:23847-1248
Practice Address - Country:US
Practice Address - Phone:434-336-5300
Practice Address - Fax:434-336-5301
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208064208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation