Individual
MR. RYAN CASEY WILLIAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
304 W HAY ST, SUITE 218, DECATUR, IL 62526-6328
(217) 877-2088
(217) 877-3622
Mailing address
304 W HAY ST, SUITE 218, DECATUR, IL 62526-6328
(217) 877-2088
(217) 877-3622
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002425
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902989379
NPI
IL
Enumeration date
09/02/2010
Last updated
09/02/2010
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