| NPI | 1801286778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN J. WILLIS Doctor Of Podiatric Medicine 262-960-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WY 147) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |