Organization
J R WILLIS DC PC
Active
Other names
Willis Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
LEE R WILLIS DC (CHIROPRACTOR)
(276) 228-3883
Entity
Organization
Contact information
Practice address
1512 N WALKER ST, PRINCETON, WV 24740-2639
(304) 487-8985
(304) 425-1680
Mailing address
570 E MAIN ST, WYTHEVILLE, VA 24382-2033
(276) 228-3883
(276) 223-1357
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104001278
VA
111N00000X
Chiropractor
Primary
589
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0131755000
—
WV
Enumeration date
10/04/2005
Last updated
08/22/2020
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