Individual
GARY DAVID WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4535
(805) 781-4711
Mailing address
4650 PARKHILL RD, SANTA MARGARITA, CA 93453-9650
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
29244
CA
Other
Enumeration date
01/01/2007
Last updated
07/08/2007
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