Provider Demographics
NPI:1700843786
Name:WILLS, CHAD CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:CHRISTOPHER
Last Name:WILLS
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 1:1000 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 402
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5481
Mailing Address - Country:US
Mailing Address - Phone:239-331-6060
Mailing Address - Fax:941-882-6231
Practice Address - Street 1:1000 TAMIAMI TRL N
Practice Address - Street 2:SUITE 402
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5481
Practice Address - Country:US
Practice Address - Phone:239-331-6060
Practice Address - Fax:941-882-6231
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70651ZMedicare PIN
FLU99677Medicare UPIN