Individual
TRAE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
559 VINCENT ST, SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
(720) 628-6697
Mailing address
559 VINCENT ST, SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
(720) 628-6697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2024
Last updated
07/14/2026
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