Healthcare Provider Details

I. General information

NPI: 1841905122
Provider Name (Legal Business Name): DR. ELIZABETH HUFF WILLIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2023
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6789 ELM VALLEY DR
KALAMAZOO MI
49009-7476
US

IV. Provider business mailing address

6789 ELM VALLEY DR
KALAMAZOO MI
49009-7476
US

V. Phone/Fax

Practice location:
  • Phone: 269-544-3230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: