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Individual

JEFFREY W WILLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
1010 MONARCH ST, SUITE 150, LEXINGTON, KY 40513-1497
(859) 219-0211
(859) 219-0241
Mailing address
1010 MONARCH ST, SUITE 150, LEXINGTON, KY 40513-1497
(859) 219-0211
(859) 219-0241

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3720
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000385840
BC/BS
KY
01
P400037267
MEDICARE PTAN
KY
Enumeration date
06/01/2006
Last updated
04/24/2013
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