Individual
JACK WILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26351 PATRIOTS WAY, GEORGETOWN, DE 19947-2575
(302) 933-3000
Mailing address
17652 MCCOLLEYS CHAPEL RD, GEORGETOWN, DE 19947-3142
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
C9-0000265
DE
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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