MEDICARE: DR. ADAM CHRISTOPHER WILLIS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH7276	FL

General Provider Information

NPI Number	:	1538499066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM CHRISTOPHER WILLIS DC

Provider Business Mailing Address
First Line	:	2424 NAVAREZ AVE
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-2107
Country	:	US
Telephone Number	:	813-879-6200
Fax Number	:	813-872-1583

Provider Business Practice Location Address
First Line	:	2604 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-1835
Country	:	US
Telephone Number	:	813-879-6200
Fax Number	:	813-872-1583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2010
Last Update Date	:	01/06/2010

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