Provider Demographics
NPI:1538499066
Name:WILLIS, ADAM CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CHRISTOPHER
Last Name:WILLIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 NAVAREZ AVE
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-2107
Mailing Address - Country:US
Mailing Address - Phone:813-879-6200
Mailing Address - Fax:813-872-1583
Practice Address - Street 1:2604 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1835
Practice Address - Country:US
Practice Address - Phone:813-879-6200
Practice Address - Fax:813-872-1583
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor