DAVID WILLIS DO PA
Marriage and Family Therapists at Leather Fern Ln, Mims, FL

License number
Florida OS9622
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DAVID WILLIS D.O.
Title: OWNER
Phone: (407) 421-3599
Address
Address
919 Leather Fern Ln, Mims, FL 32754
National Provider ID: 1932310679
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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David Willis, D.O., PA

New Smyrna, FL  -  Mims, FL

Status:
Inactive
Registration:
May 15, 2007
Addresses:
408 State Rd 44, New Smyrna, FL 32168
919 Leather Fern Ln, Mims, FL 32754
State ID:
P07000059408
Business type:
Domestic for Profit Corporation
Director:
David Willis Director, inactive

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