Provider Demographics
NPI:1730269531
Name:WILLS CHIROPRACTIC CLINIC, P.C.
Entity type:Organization
Organization Name:WILLS CHIROPRACTIC CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:308-436-7176
Mailing Address - Street 1:416 VALLEY VIEW DR STE 1300
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1459
Mailing Address - Country:US
Mailing Address - Phone:308-436-7176
Mailing Address - Fax:308-436-2092
Practice Address - Street 1:416 VALLEY VIEW DR STE 1300
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1459
Practice Address - Country:US
Practice Address - Phone:308-436-7176
Practice Address - Fax:308-436-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty