Provider Demographics
NPI:1427531433
Name:WILLIAMS, TRENETHA MICHELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:TRENETHA
Middle Name:MICHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 FLINT ST
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604-1912
Mailing Address - Country:US
Mailing Address - Phone:251-377-9229
Mailing Address - Fax:
Practice Address - Street 1:1111 LOWER FAYETTEVILLE RD STE 2000
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-6506
Practice Address - Country:US
Practice Address - Phone:770-251-7284
Practice Address - Fax:770-251-7295
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH9038225100000X
GAPT013783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist