Provider Demographics
NPI:1457572919
Name:WILLIAMS, SHARON MARIE (PTA)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 HORNBEAM RD.
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437
Mailing Address - Country:US
Mailing Address - Phone:918-652-8974
Mailing Address - Fax:
Practice Address - Street 1:1924 W. MANI ST.
Practice Address - Street 2:
Practice Address - City:HENRYETTA
Practice Address - State:OK
Practice Address - Zip Code:74437
Practice Address - Country:US
Practice Address - Phone:918-652-0288
Practice Address - Fax:918-650-9281
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant