Provider Demographics
NPI:1841548088
Name:WILLIAMS, JASON BRYAN (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:BRYAN
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:RR1 BOX 10556
Mailing Address - Street 2:THE VILLAGE MALL BAY12
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00850-9604
Mailing Address - Country:US
Mailing Address - Phone:340-773-4300
Mailing Address - Fax:340-773-4301
Practice Address - Street 1:RR1 BOX 10556
Practice Address - Street 2:THE VILLAGE MALL BAY12
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00850-9604
Practice Address - Country:US
Practice Address - Phone:340-773-4300
Practice Address - Fax:340-773-4301
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI62111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor