| NPI | 1255484713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN C WILLIS Chiropractor 276-963-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: VA 0104000181) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: VA 0104556270) |
| 111N00000X Chiropractor (Licence: VA 0104556501) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-12-12 |