Provider Demographics
NPI:1053711051
Name:WILLIAMS, KARI (ATC)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HASTINGS DR
Mailing Address - Street 2:
Mailing Address - City:FALLING WATERS
Mailing Address - State:WV
Mailing Address - Zip Code:25419-4641
Mailing Address - Country:US
Mailing Address - Phone:304-704-1863
Mailing Address - Fax:
Practice Address - Street 1:1502 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3497
Practice Address - Country:US
Practice Address - Phone:304-704-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002241A2255A2300X
KYAT8702255A2300X
MDA00005022255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer