Provider Demographics
NPI:1639238843
Name:WILLIAMS, GERY WAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:GERY
Middle Name:WAYNE
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 1:103 W. LYNN ST.
Mailing Address - Street 2:
Mailing Address - City:STRYKER
Mailing Address - State:OH
Mailing Address - Zip Code:43557-1600
Mailing Address - Country:US
Mailing Address - Phone:419-682-4361
Mailing Address - Fax:419-682-4362
Practice Address - Street 1:103 W. LYNN ST.
Practice Address - Street 2:
Practice Address - City:STRYKER
Practice Address - State:OH
Practice Address - Zip Code:43557-1600
Practice Address - Country:US
Practice Address - Phone:419-682-4361
Practice Address - Fax:419-682-4362
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC. 648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor