Provider Demographics
NPI:1215706221
Name:WILLIAMS, ISAYEL RASHAD (PTA)
Entity type:Individual
Prefix:
First Name:ISAYEL
Middle Name:RASHAD
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 NORTHRIDGE OVAL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144-3256
Mailing Address - Country:US
Mailing Address - Phone:216-732-0290
Mailing Address - Fax:
Practice Address - Street 1:511 NORTHRIDGE OVAL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3256
Practice Address - Country:US
Practice Address - Phone:216-732-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH011486225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty