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1174066492
CHARLES C WILLIS
CHICAGO, IL
NPI
1174066492
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160007583)
Enumeration Date
2016-11-18
Last Update Date
2016-11-18
Business Address
-- CHARLES C WILLIS
2649 E 75TH ST
CHICAGO, IL 60649-3835
Phone number: 773-356-9300
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Mailing Address
-- CHARLES C WILLIS
2649 E 75TH ST
CHICAGO, IL 60649-3835
Phone number:
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