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NPI Code Detail

MEDICARE: DR. DAVID JASON WILLS D.C.

MEDICARE:  DR. DAVID JASON WILLS  D.C.
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
1111N00000XChiropractorCE006568MO

General Provider Information

NPI Number : 1558513804
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID JASON WILLS D.C.
Provider Business Mailing Address
First Line : 703 OLIVE ST
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63101-2202
Country : US
Telephone Number : 314-703-4439
Fax Number :
Provider Business Practice Location Address
First Line : 703 OLIVE
Second Line :
City : ST.LOUIS
State : MO
Zip : 63101-2202
Country : US
Telephone Number : 314-703-4439
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2008
Last Update Date : 10/17/2008

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Directions to “ DR. DAVID JASON WILLS D.C.” Practice Location

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