Provider Demographics
NPI:1528312592
Name:WILLIAMS, JENNIFER FAITH (MS, ATC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:FAITH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:FAITH
Other - Last Name:RYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, ATC
Mailing Address - Street 1:190 CAMPUS BLVD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:540-667-9252
Mailing Address - Fax:540-722-4514
Practice Address - Street 1:190 CAMPUS BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-667-9252
Practice Address - Fax:540-722-4514
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0126001623207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery