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1063664183
JACK K WILLIS
MIDLAND, TX
NPI
1063664183
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: TX PA05950)
Enumeration Date
2008-10-21
Last Update Date
2015-08-06
Business Address
-- JACK K WILLIS PA
407 KENT ST
MIDLAND, TX 79701-5858
Phone number: 432-687-2273
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Mailing Address
-- JACK K WILLIS PA
407 KENT ST
MIDLAND, TX 79701-5858
Phone number: 432-687-2273
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