# FIVE STAR FEET, LLC

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

## Provider details

- **NPI number:** 1801286778
- **Authorized official:** DR. BENJAMIN J. WILLIS D.P.M. (DOCTOR OF PODIATRIC MEDICINE)
- **Authorized official phone:** (262) 960-5101

## Contact information

- **Practice address:** 2525 ROAD 218, CHEYENNE, WY 82009-9103
- **Practice address phone:** (262) 960-5101
- **Mailing address:** 2525 ROAD 218, CHEYENNE, WY 82009-9103
- **Mailing address phone:** (262) 960-5101

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 147 | WY | Yes |

## Other

- **Enumeration date:** 01/30/2015
- **Last updated:** 01/30/2015