NPI | 1366403529 |
---|---|
Doing Business As | WILLIS CHIRO MED |
Entity Type | Organization |
Authorized Contact | SUELLYN GARD WILLIS Senior Om 803-699-0293 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 1078) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2020-08-22 |