Provider Demographics
NPI:1962500751
Name:BETH WILLIAMS DC PA
Entity Type:Organization
Organization Name:BETH WILLIAMS DC PA
Other - Org Name:CORNERSTONE HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-965-8665
Mailing Address - Street 1:2328 S CONGRESS AVE STE 2E
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-7674
Mailing Address - Country:US
Mailing Address - Phone:561-965-8665
Mailing Address - Fax:561-965-2760
Practice Address - Street 1:2328 S CONGRESS AVE STE 2E
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406
Practice Address - Country:US
Practice Address - Phone:561-965-8665
Practice Address - Fax:561-965-2760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7399261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381765200Medicaid
FLK6077Medicare ID - Type UnspecifiedMEDICARE GROUP PART B
FL381765200Medicaid