Provider Demographics
NPI:1699290635
Name:WILLIAMS, AUSTIN (DR)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1730 DICKERSON BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-2884
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7427 MATTHEWS MINT HILL RD STE 103
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-7863
Practice Address - Country:US
Practice Address - Phone:980-729-6525
Practice Address - Fax:980-729-6530
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP17342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist