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Organization

WILLIS CHIROPRACTIC OFFICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN C WILLIS CH (CHIROPRACTOR)
(276) 963-0395
Entity
Organization

Contact information

Practice address
305 ALLEGHENY ST, RICHLANDS, VA 24641-2346
(276) 963-0395
(276) 964-2225
Mailing address
PO BOX 1045, RICHLANDS, VA 24641-1045
(276) 963-0395
(276) 964-2225

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000181
VA
111N00000X
Chiropractor
0104556270
VA
111N00000X
Chiropractor
0104556501
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007315
ANTHEM BLUE CROSS BLUE SH
VA
01
1300519
UNITED MINE WORKERS UMWA
VA
01
145963
ANTHEM BLUE CROSS BLUE SH
VA
01
4669783
AETNA
VA
01
7880576
AETNA
VA
Enumeration date
01/19/2007
Last updated
12/12/2007
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