Provider Demographics
NPI:1861449845
Name:WILLIAMS, DARRYL JUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:JUAN
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 1:1105 SUNSET RD
Mailing Address - Street 2:SUITE E AND F
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2290
Mailing Address - Country:US
Mailing Address - Phone:609-387-1910
Mailing Address - Fax:609-387-5122
Practice Address - Street 1:1105 SUNSET RD
Practice Address - Street 2:SUITE E AND F
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2290
Practice Address - Country:US
Practice Address - Phone:609-387-1910
Practice Address - Fax:609-387-5122
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00591600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor