Provider Demographics
NPI:1730364688
Name:WILLIAMS, MASCHA LOREA (DC)
Entity type:Individual
Prefix:DR
First Name:MASCHA
Middle Name:LOREA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 11230
Mailing Address - Street 2:
Mailing Address - City:KINGSHILL
Mailing Address - State:VI
Mailing Address - Zip Code:00850-9618
Mailing Address - Country:US
Mailing Address - Phone:340-772-2225
Mailing Address - Fax:340-772-5900
Practice Address - Street 1:1A CLIFTON HILL
Practice Address - Street 2:
Practice Address - City:KINGSHILL
Practice Address - State:VI
Practice Address - Zip Code:00850
Practice Address - Country:US
Practice Address - Phone:340-772-2225
Practice Address - Fax:340-772-5900
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30409111N00000X
VI56111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor