Healthcare Provider Details

I. General information

NPI: 1427985605
Provider Name (Legal Business Name): WILLIS CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8641 WATSON RD
SAINT LOUIS MO
63119-5109
US

IV. Provider business mailing address

8641 WATSON RD
SAINT LOUIS MO
63119-5109
US

V. Phone/Fax

Practice location:
  • Phone: 314-962-3130
  • Fax: 314-962-7233
Mailing address:
  • Phone: 314-962-3130
  • Fax: 314-962-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DAMEON LEE WILLIS
Title or Position: DOCTOR
Credential: DC
Phone: 314-586-5434