Provider Demographics
NPI:1891185559
Name:RONALD WILLIAMS CHIROPRACTIC CLINIC, INC
Entity Type:Organization
Organization Name:RONALD WILLIAMS CHIROPRACTIC CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:707-643-3768
Mailing Address - Street 1:PO BOX 4422
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-0442
Mailing Address - Country:US
Mailing Address - Phone:707-643-3768
Mailing Address - Fax:707-643-4029
Practice Address - Street 1:541 CURTOLA PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-6924
Practice Address - Country:US
Practice Address - Phone:707-643-3768
Practice Address - Fax:707-643-4029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty