Provider Demographics
NPI:1760400097
Name:WILLS, DAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:
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 1:1412 ATHENS DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-7820
Mailing Address - Country:US
Mailing Address - Phone:513-600-3028
Mailing Address - Fax:
Practice Address - Street 1:1412 ATHENS DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-7820
Practice Address - Country:US
Practice Address - Phone:513-600-3028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor