Individual
LUKE WILLIAM WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT
Contact information
Practice address
1965 SHAWNEE DR, COLORADO SPRINGS, CO 80915-1920
(719) 375-4057
Mailing address
1965 SHAWNEE DR, COLORADO SPRINGS, CO 80915-1920
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
02/05/2010
Last updated
02/05/2010
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