Individual
JASON WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA, NSCA-CPT
Contact information
Practice address
4215 LANDING DR, 2C, AURORA, IL 60504-5017
(224) 688-4040
Mailing address
4215 LANDING DR, 2C, AURORA, IL 60504-5017
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7173161008
CO
225200000X
Physical Therapy Assistant
Primary
160004341
IL
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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