Individual
BRIAN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
506 MANCHESTER EXPY STE A, COLUMBUS, GA 31904-6444
(706) 653-9343
(706) 653-9242
Mailing address
2828 9TH ST, COLUMBUS, GA 31906-3206
(706) 653-9343
(706) 653-9242
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
04/08/2014
Last updated
04/08/2014
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