Provider Demographics
NPI:1588611412
Name:WILLEY, STACEY L (DC)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:L
Last Name:WILLEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:L
Other - Last Name:TOWNSEND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1967 SPRUCE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-2624
Mailing Address - Country:US
Mailing Address - Phone:563-293-3616
Mailing Address - Fax:866-421-3726
Practice Address - Street 1:1967 SPRUCE HILLS DR
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2624
Practice Address - Country:US
Practice Address - Phone:309-793-7000
Practice Address - Fax:866-421-3726
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007626111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor