Provider Demographics
NPI:1144340035
Name:WILLIAMS, JAMIE ERIN (PT)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ERIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 ALYSSUM PL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-7548
Mailing Address - Country:US
Mailing Address - Phone:336-782-8123
Mailing Address - Fax:
Practice Address - Street 1:4410 PROVIDENCE LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3254
Practice Address - Country:US
Practice Address - Phone:336-896-9999
Practice Address - Fax:336-759-2020
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist