Provider Demographics
NPI:1538545819
Name:WILLIAMS, MELISSA CAITLIN (DPT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAITLIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 HAMILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:39813-1302
Mailing Address - Country:US
Mailing Address - Phone:229-308-1579
Mailing Address - Fax:229-723-2354
Practice Address - Street 1:1218 HAMILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:GA
Practice Address - Zip Code:39813-1302
Practice Address - Country:US
Practice Address - Phone:229-308-1579
Practice Address - Fax:229-723-2354
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist