Provider Demographics
NPI:1952443343
Name:WILLIAMS, LISA K (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:K
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 N DRUID HILLS RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3015
Mailing Address - Country:US
Mailing Address - Phone:404-874-2002
Mailing Address - Fax:404-874-0390
Practice Address - Street 1:3802 N DRUID HILLS RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3015
Practice Address - Country:US
Practice Address - Phone:404-874-2002
Practice Address - Fax:404-874-0390
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCBVWMedicare ID - Type Unspecified