Provider Demographics
NPI:1629482385
Name:WILLIAMS, JOYCE ANN (PTA)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:ANN
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:810 KING ST
Mailing Address - Street 2:
Mailing Address - City:WRAY
Mailing Address - State:CO
Mailing Address - Zip Code:80758-2010
Mailing Address - Country:US
Mailing Address - Phone:970-520-1953
Mailing Address - Fax:
Practice Address - Street 1:700 MAIN ST
Practice Address - Street 2:
Practice Address - City:WRAY
Practice Address - State:CO
Practice Address - Zip Code:80758-1739
Practice Address - Country:US
Practice Address - Phone:970-322-3471
Practice Address - Fax:970-322-3487
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2024-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTA0012119225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant