Provider Demographics
NPI:1598017980
Name:WILLIAMSON, ROBERT J (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:WILLIAMSON
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 1:100 WILLOWBROOK DR
Mailing Address - Street 2:APT 66
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-1000
Mailing Address - Country:US
Mailing Address - Phone:304-488-7309
Mailing Address - Fax:
Practice Address - Street 1:368 MAIN ST W
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1427
Practice Address - Country:US
Practice Address - Phone:304-372-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor