Individual
DR. GARY L WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
317 N MAIN ST, ALPHARETTA, GA 30009-2321
(770) 740-8740
Mailing address
317 N MAIN ST, ALPHARETTA, GA 30009-2321
(770) 740-8740
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1615
AL
111N00000X
Chiropractor
Primary
2788
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
581878777
FED EMPL ID #
GA
Enumeration date
10/14/2005
Last updated
11/16/2018
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