Provider Demographics
NPI:1013978923
Name:WILLIAMSON, JOSHUA DAVID (LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAVID
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N LEE HWY
Mailing Address - Street 2:APT # 9
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3759
Mailing Address - Country:US
Mailing Address - Phone:540-458-8213
Mailing Address - Fax:540-458-8173
Practice Address - Street 1:204 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2116
Practice Address - Country:US
Practice Address - Phone:540-458-8213
Practice Address - Fax:540-458-8173
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01260008272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer