Provider Demographics
NPI:1528390325
Name:WILLIAMS, NOLAN (DPT)
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 SOUTH SHADES CREST RD
Mailing Address - Street 2:STE 107
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3551
Mailing Address - Country:US
Mailing Address - Phone:205-987-6501
Mailing Address - Fax:205-987-6503
Practice Address - Street 1:3421 SOUTH SHADES CREST RD
Practice Address - Street 2:STE 107
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3551
Practice Address - Country:US
Practice Address - Phone:205-987-6501
Practice Address - Fax:205-987-6503
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH5744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist