Basic Information
| Provider Information | |||||||||
| NPI: | 1467704056 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | LYNN | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37250 5 MILE RD | ||||||||
| Address2: | UNIT D1 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481541848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344623240 | ||||||||
| FaxNumber: | 7344623831 | ||||||||
| Practice Location | |||||||||
| Address1: | 37250 5 MILE RD | ||||||||
| Address2: | UNIT D1 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481541848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344623240 | ||||||||
| FaxNumber: | 7344623831 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2012 | ||||||||
| LastUpdateDate: | 10/08/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501016097 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.