Individual
MR. JACK PARKER WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
5690 WEAVER RD, CONNEAUT, OH 44030-9798
(440) 813-4223
Mailing address
5690 WEAVER RD, CONNEAUT, OH 44030
(440) 813-4223
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
870
OH
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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