Provider Demographics
NPI:1003879602
Name:WILLIAMS, DALE FRANCISCO (DC)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:FRANCISCO
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 1:1993 HAMILTON BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:SOUTH BOSTON
Mailing Address - State:VA
Mailing Address - Zip Code:24592-2146
Mailing Address - Country:US
Mailing Address - Phone:434-575-5130
Mailing Address - Fax:434-575-7570
Practice Address - Street 1:1993 HAMILTON BLVD
Practice Address - Street 2:STE A
Practice Address - City:SOUTH BOSTON
Practice Address - State:VA
Practice Address - Zip Code:24592-2146
Practice Address - Country:US
Practice Address - Phone:434-575-5130
Practice Address - Fax:434-575-7570
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1608111N00000X
VA0104556822111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC244526Medicare ID - Type Unspecified
NCT64538Medicare UPIN