Provider Demographics
NPI:1801186358
Name:WILLIS, ALESHA K (DC)
Entity Type:Individual
Prefix:DR
First Name:ALESHA
Middle Name:K
Last Name:WILLIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 630821
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80163-0821
Mailing Address - Country:US
Mailing Address - Phone:404-790-5664
Mailing Address - Fax:720-306-8987
Practice Address - Street 1:9370 S COLORADO BLVD
Practice Address - Street 2:#A-10
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5205
Practice Address - Country:US
Practice Address - Phone:303-471-9355
Practice Address - Fax:720-306-8987
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-17
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6719111N00000X
GACHIR008805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor