Individual
AUSTIN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
96 JONATHAN LUCAS ST, CHARLESTON, SC 29425-7963
(843) 792-1414
Mailing address
3530 VERDIER BLVD UNIT 411, CHARLESTON, SC 29414-7963
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/03/2025
Last updated
04/04/2025
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