MEDICARE: DR. THOMAS CAMERON 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
1	111NX0100X	Occupational Health Chiropractor	2491	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306850193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS CAMERON WILLS D.C.

Provider Business Mailing Address
First Line	:	4424 WILD THICKET LN
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29420-7436
Country	:	US
Telephone Number	:	843-225-7746
Fax Number	:	843-225-7749

Provider Business Practice Location Address
First Line	:	8626 DORCHESTER RD
Second Line	:	101
City	:	N CHARLESTON
State	:	SC
Zip	:	29420-7328
Country	:	US
Telephone Number	:	843-225-7746
Fax Number	:	843-225-7749

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

Provider Enumeration Date	:	07/28/2006
Last Update Date	:	07/09/2007

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