Individual
MR. TOMMY WILLIAMS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
INC
Contact information
Practice address
1439 BAY RD, WALLACE, NC 28466-9530
(910) 441-5415
Mailing address
1439 BAY RD, WALLACE, NC 28466-9530
(910) 441-5415
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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