Individual
JOHNATHAN GRANT WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1601 MAPLE ST, CARROLLTON, GA 30118-0001
(678) 839-5000
Mailing address
151 HOLLY ST, WINFIELD, AL 35594-3821
(205) 495-9964
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2325
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000030441
BOARD OF CERTIFICATION NUMBER
—
Enumeration date
07/23/2019
Last updated
11/27/2023
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