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Organization

JESSICA WILLIAMS

Active
Parent organization
OWNER
Other names
WILLIAMS
Organization subpart
Yes

Provider details

NPI number
Legal business name
OWNER
Authorized official
MRS. JESSICA WILLIAMS (OWER)
(318) 201-2080
Entity
Organization

Contact information

Practice address
108 WAYNE ST, PINEVILLE, LA 71360-6733
(318) 201-2080
Mailing address
108 WAYNE ST, PINEVILLE, LA 71360
(318) 201-2080

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
Primary
LA

Other

Enumeration date
11/18/2009
Last updated
11/18/2009
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