Individual
WILLIA D KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
308 E FAIRLANE DR, LONGVIEW, TX 75604-1729
(903) 930-5824
Mailing address
308 E FAIRLANE DR, LONGVIEW, TX 75604-1729
(903) 930-5824
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
550809477
TX
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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