Provider Demographics
NPI:1598462723
Name:WILLIAMS, FROSTINE MARIE (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:FROSTINE
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:F
Other - Middle Name:MARIE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SPECIALIST
Mailing Address - Street 1:10408 COURTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-1712
Mailing Address - Country:US
Mailing Address - Phone:571-225-0494
Mailing Address - Fax:
Practice Address - Street 1:10408 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-1712
Practice Address - Country:US
Practice Address - Phone:571-225-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier