Provider Demographics
NPI:1902378912
Name:WILLIAMS, LATONYA YVONNE
Entity Type:Individual
Prefix:
First Name:LATONYA
Middle Name:YVONNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3162 WILSON CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3440
Mailing Address - Country:US
Mailing Address - Phone:901-644-2749
Mailing Address - Fax:
Practice Address - Street 1:3162 WILSON CV
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-3440
Practice Address - Country:US
Practice Address - Phone:901-644-2749
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHand