# PROHEALTH INTEGRATED MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588782346
- **Authorized official:** DR. CHRISTOPHER P WILLIS D.C. (OWNER)
- **Authorized official phone:** (770) 513-0111

## Contact information

- **Practice address:** 1431 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5946
- **Practice address phone:** (770) 513-0111
- **Practice address fax:** (770) 513-3731
- **Mailing address:** 1431 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5946
- **Mailing address phone:** (770) 513-0111
- **Mailing address fax:** (770) 513-3731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CHIR005026 | GA | — |
| 173000000X | Legal Medicine | 016356 | GA | Yes |

## Other

- **Enumeration date:** 03/27/2007
- **Last updated:** 11/08/2010