Individual
SUSAN LYNN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
134 EXECUTIVE DR, SUITE 3, LAFAYETTE, IN 47905
(765) 448-6489
(765) 448-9775
Mailing address
PO BOX 5943, LAFAYETTE, IN 47903-5943
(765) 448-6489
(765) 448-9775
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
008001427A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10787204
CAQH
—
05
—
200129120A
—
IN
01
—
350054830
RRMM
—
Enumeration date
02/12/2007
Last updated
09/19/2011
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