Individual
TANIJA S WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 W TRADE ST, CHARLOTTE, NC 28202-1143
(704) 440-3580
Mailing address
10506 GROBIE WAY APT 206, CHARLOTTE, NC 28216-0251
(980) 405-4540
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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