Provider Demographics
NPI:1619207024
Name:WILLIAMSON WELLNESS
Entity Type:Organization
Organization Name:WILLIAMSON WELLNESS
Other - Org Name:NASHVILLE HEMORRHOID CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANGELIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-472-8565
Mailing Address - Street 1:377 RIVERSIDE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-5393
Mailing Address - Country:US
Mailing Address - Phone:615-472-8565
Mailing Address - Fax:
Practice Address - Street 1:377 RIVERSIDE DR STE 310
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5393
Practice Address - Country:US
Practice Address - Phone:615-472-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-07
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17177261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service