Gary Howard Willis II, O.T.

NPI #1710050414 in Chubbuck, Idaho

Provider Information

NPI Number: 1710050414
Entity Type: Individual
Name: Gary Howard Willis II, O.T.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: O.T.
Enumeration Date: Nov 17, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 4473 FOX CT
City: Chubbuck
State: Idaho
ZIP Code: 83202-2670
Phone: (208) 604-0800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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