Individual
MR. DENNIS DEMETRIUS WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,ATC,LAT,PES,CES
Contact information
Practice address
1179 MADISON GREEN DR, FORT MILL, SC 29715
(864) 525-8821
Mailing address
1179 MADISON GREEN DR, FORT MILL, SC 29715-8321
(864) 525-8821
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0604
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207PS0010X
SPORTS MEDICINE
NC
Enumeration date
05/23/2017
Last updated
07/19/2018
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