Provider Demographics
NPI:1851670491
Name:WILLIAMS, YVONNE P (LPTA)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6222
Mailing Address - Country:US
Mailing Address - Phone:252-977-9795
Mailing Address - Fax:
Practice Address - Street 1:201 N GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6222
Practice Address - Country:US
Practice Address - Phone:252-977-9795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-14
Last Update Date:2011-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC741225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant