Provider Demographics
NPI:1922447689
Name:HORIZON SPINAL WELLNESS CENTER,INC.
Entity Type:Organization
Organization Name:HORIZON SPINAL WELLNESS CENTER,INC.
Other - Org Name:J. TODD WILLIAMS, DCPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-437-1155
Mailing Address - Street 1:16050 S TAMIAMI TRL STE 109
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4243
Mailing Address - Country:US
Mailing Address - Phone:239-437-1155
Mailing Address - Fax:239-437-1451
Practice Address - Street 1:16050 S TAMIAMI TRL STE 109
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4243
Practice Address - Country:US
Practice Address - Phone:239-437-1155
Practice Address - Fax:239-437-1451
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J. TODD WILLIAMS,DCPA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003812111N00000X
FLOS5873208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty