Organization
FIVE STAR FEET, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN J. WILLIS D.P.M. (DOCTOR OF PODIATRIC MEDICINE)
(262) 960-5101
Entity
Organization
Contact information
Practice address
2525 ROAD 218, CHEYENNE, WY 82009-9103
(262) 960-5101
Mailing address
2525 ROAD 218, CHEYENNE, WY 82009-9103
(262) 960-5101
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
147
WY
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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