Individual
JONATHAN WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
19 LORIS RD, PEABODY, MA 01960-1618
(978) 979-1411
Mailing address
19 LORIS RD, PEABODY, MA 01960-1618
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2406
MA
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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