Individual
EBONY WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
918 TYLER ST, JACKSONVILLE, FL 32209-7623
(904) 662-6612
Mailing address
918 TYLER ST, JACKSONVILLE, FL 32209-7623
(904) 619-2827
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
18782
FL
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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