Provider Demographics
NPI:1558465559
Name:WILLIAMS, QUINTON NMANDI (DC)
Entity Type:Individual
Prefix:
First Name:QUINTON
Middle Name:NMANDI
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17026 DEVONSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-1617
Mailing Address - Country:US
Mailing Address - Phone:818-273-7396
Mailing Address - Fax:818-875-3228
Practice Address - Street 1:17026 DEVONSHIRE ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-1617
Practice Address - Country:US
Practice Address - Phone:818-273-7396
Practice Address - Fax:818-875-3228
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30067111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor