Provider Demographics
NPI:1972873982
Name:WILLIAMS, STEVEN LAVAUGHN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LAVAUGHN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 S NORTHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-3416
Mailing Address - Country:US
Mailing Address - Phone:334-322-4835
Mailing Address - Fax:
Practice Address - Street 1:234 S NORTHINGTON ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36067-3416
Practice Address - Country:US
Practice Address - Phone:334-322-4835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant