Provider Demographics
NPI:1710999099
Name:WILLIAMS, DAMON S (PT, STS, CES)
Entity Type:Individual
Prefix:DR
First Name:DAMON
Middle Name:S
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT, STS, CES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7342 STONECREST CONCOURSE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6989
Mailing Address - Country:US
Mailing Address - Phone:678-526-5400
Mailing Address - Fax:678-669-6222
Practice Address - Street 1:7342 STONECREST CONCOURSE
Practice Address - Street 2:SUITE A
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6989
Practice Address - Country:US
Practice Address - Phone:678-526-5400
Practice Address - Fax:678-669-6222
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT006270225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist