Individual
MR. JACOB DANNER WILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
2545 SCHOENERSVILLE RD, 5TH FLOOR LVH-M SOUTH, BETHLEHEM, PA 18017-7300
(484) 884-6503
(484) 884-6504
Mailing address
1605 N CEDAR CREST BLVD STE 411, ALLENTOWN, PA 18104-2323
(610) 969-1914
(610) 969-3951
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA055271
PA
363A00000X
Physician Assistant
OA002759
PA
363AM0700X
Medical Physician Assistant
Primary
MA055271
PA
Other
Enumeration date
10/26/2011
Last updated
04/21/2020
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