Provider Demographics
NPI:1871798405
Name:WILLIAMS, FREDRICK (L AC)
Entity type:Individual
Prefix:
First Name:FREDRICK
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ANTELOPE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-9418
Mailing Address - Country:US
Mailing Address - Phone:704-524-6809
Mailing Address - Fax:888-392-8699
Practice Address - Street 1:17232 LANCASTER HWY
Practice Address - Street 2:SUITE 112
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2002
Practice Address - Country:US
Practice Address - Phone:704-524-6809
Practice Address - Fax:888-392-8699
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC448171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist