Provider Demographics
NPI:1801378815
Name:WILLIAMSON, JAMES (DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 DEVONSHIRE AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2502
Mailing Address - Country:US
Mailing Address - Phone:917-715-5290
Mailing Address - Fax:
Practice Address - Street 1:7676 PETERS RD STE C
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4032
Practice Address - Country:US
Practice Address - Phone:954-474-4403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist