Organization
PROHEALTH INTEGRATED MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER P WILLIS D.C. (OWNER)
(770) 513-0111
Entity
Organization
Contact information
Practice address
1431 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5946
(770) 513-0111
(770) 513-3731
Mailing address
1431 RIVERSIDE PKWY, LAWRENCEVILLE, GA 30043-5946
(770) 513-0111
(770) 513-3731
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIR005026
GA
173000000X
Legal Medicine
Primary
016356
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841233905
NPI NUMBER
GA
01
—
1841244175
NPI NUMBER
GA
Enumeration date
03/27/2007
Last updated
11/08/2010
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