Organization
I E WILLIS JR DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SELWYN EUGENE WILLIS DPM (DPM)
(903) 753-3316
Entity
Organization
Contact information
Practice address
609 E WHALEY ST, LONGVIEW, TX 75601-6526
(903) 753-3316
Mailing address
PO BOX 2202, LONGVIEW, TX 75606-2202
(903) 753-3316
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0280
TX
Other
Enumeration date
02/05/2008
Last updated
02/21/2008
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