Provider Demographics
NPI:1336266683
Name:WILLIAMS, JOSEE (PT, CSCS, CERT MDT)
Entity Type:Individual
Prefix:MRS
First Name:JOSEE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, CSCS, CERT MDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W STUART DR
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-2114
Mailing Address - Country:US
Mailing Address - Phone:276-238-8900
Mailing Address - Fax:276-238-8904
Practice Address - Street 1:106 W STUART DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2114
Practice Address - Country:US
Practice Address - Phone:276-238-8900
Practice Address - Fax:276-238-8904
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305006710225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA650000460Medicare ID - Type Unspecified