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General NPI Number Information
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NPI Number | 1578706370
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Entity Type | Organization
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Legal Business Name | JEFFREY WILLIS CHIROPRACTIC CORPORATION
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 24868 APPLE ST STE 101
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City | SANTA CLARITA
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State | CA
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Zip | 91321-5038
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Country | US
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Telephone | 661-290-2400
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Fax | 661-290-2422
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Provider Business Mailing Address
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Address Line | 24868 APPLE ST STE 101
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City | SANTA CLARITA
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State | CA
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Zip | 91321-5038
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Country | US
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Telephone | 661-290-2400
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Fax | 661-290-2422
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFF SCOTT WILLIS
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Credential | D.C.
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Telephone | 661-295-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 30535
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License Number State | CA
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