Provider Demographics
NPI:1568560332
Name:WILLIAMS, BETH LEA (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:LEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 S CONGRESS AVE STE 2E
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7674
Mailing Address - Country:US
Mailing Address - Phone:561-965-8665
Mailing Address - Fax:561-965-2760
Practice Address - Street 1:2328 S CONGRESS AVE STE 2E
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-965-8665
Practice Address - Fax:561-965-2760
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7399111N00000X
GACHIR007952111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381174300Medicaid
FL381765200Medicaid
FL381174300Medicaid
FL686738Medicare ID - Type UnspecifiedPART A GROUP# PT
FLE1491ZMedicare ID - Type Unspecified
FLK6077Medicare ID - Type UnspecifiedGROUP#