Willis Chiro Med Of Florence Llc | |
1501 Heritage Ln Florence SC 29505-3141 | |
(843) 665-6777 | |
(843) 665-6677 |
Full Name | Willis Chiro Med Of Florence Llc |
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Speciality | Clinic/Center |
Location | 1501 Heritage Ln, Florence, South Carolina |
Authorized Official Name and Position | Joseph Ray Willis (OWNER) |
Authorized Official Contact | 8436656777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Willis Chiro Med Of Florence Llc 1501 Heritage Ln Florence SC 29505-3141 Ph: (843) 665-6777 | Willis Chiro Med Of Florence Llc 1501 Heritage Ln Florence SC 29505-3141 Ph: (843) 665-6777 |
NPI Number | 1962779769 |
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Provider Enumeration Date | 11/22/2011 |
Last Update Date | 11/22/2011 |
Medicare PECOS PAC ID | 5496920761 |
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Medicare Enrollment ID | O20111214001070 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962779769 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 3487 (South Carolina) | Primary |
Provider Name | Joseph R Willis |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1275765448 PECOS PAC ID: 1355482837 Enrollment ID: I20100106000107 |
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