Provider Demographics
NPI:1871279380
Name:HOLIDAY WILLIAMS LLC
Entity type:Organization
Organization Name:HOLIDAY WILLIAMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:HOLIDAY
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-658-3047
Mailing Address - Street 1:99 JACKSON ST UNIT 1464
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-9862
Mailing Address - Country:US
Mailing Address - Phone:817-658-3047
Mailing Address - Fax:
Practice Address - Street 1:136 STUTTS RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6402
Practice Address - Country:US
Practice Address - Phone:817-658-3047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy