CHARLES C WILLIS

CHICAGO, IL
NPI1174066492
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IL  160007583)
Enumeration Date2016-11-18
Last Update Date2016-11-18
Business Address
-- CHARLES C WILLIS
2649 E 75TH ST
CHICAGO, IL 60649-3835
Phone number: 773-356-9300
Mailing Address
-- CHARLES C WILLIS
2649 E 75TH ST
CHICAGO, IL 60649-3835
Phone number: