Provider Demographics
NPI:1639382526
Name:WILLIAMS, JAY ALFRED (PT)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:ALFRED
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:229 SOUTH GILL STREET
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-238-5815
Mailing Address - Fax:814-238-5815
Practice Address - Street 1:1335 JOHNSON ROAD
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-263-1617
Practice Address - Fax:717-263-9799
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT001223E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist