Provider Demographics
NPI:1285155457
Name:WILLIAMS, MEGAN LAUREN (MS ATC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LAUREN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MS ATC
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:LAUREN
Other - Last Name:JULIOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ATC
Mailing Address - Street 1:5657 ARLINGTON AVE APT 37
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2067
Mailing Address - Country:US
Mailing Address - Phone:760-686-7576
Mailing Address - Fax:
Practice Address - Street 1:1395 FOOTHILL PKWY
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-0996
Practice Address - Country:US
Practice Address - Phone:805-622-9282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer