Individual
JOHN WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
121 MOORE ST, WALTERBORO, SC 29488-4463
(803) 727-2572
Mailing address
121 MOORE ST, WALTERBORO, SC 29488-4463
(803) 727-2572
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
CRC1529
SC
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
CRC1529
SC
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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