Provider Demographics
NPI:1255515425
Name:WILLIAMS, JOHN DAVID (CMT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DAVID
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5405 JONESTOWN RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-4021
Mailing Address - Country:US
Mailing Address - Phone:717-545-8412
Mailing Address - Fax:717-545-8413
Practice Address - Street 1:5405 JONESTOWN RD
Practice Address - Street 2:SUITE 108
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4021
Practice Address - Country:US
Practice Address - Phone:717-545-8412
Practice Address - Fax:717-545-8413
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist