Individual
ETHEL WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11321 MOORPARK ST UNIT 103, STUDIO CITY, CA 91602-2672
(818) 693-0308
Mailing address
11321 MOORPARK ST UNIT 103, STUDIO CITY, CA 91602-2672
(818) 693-0308
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
B6552902
CA
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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