Wallis Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH10990 Issued in FL

Legal business name

WALLIS CHIROPRACTIC LLC

Practice address

6309 Corporate CT Ste 110
Fort Myers, FL 33919-3539

Phone

(239) 433-1011

Fax

(239) 433-3737

NPI assigned

Jan 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kelly Jean Wallis, D.C.

Title

Doctor

Phone

(239) 433-1011

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles C. Dugan II, DC

  • Chiropractor
  • Fort Myers, FL
  • NPI 1265603419
  NPD (past)
• Charles Clark Dugan III, D.C.

  • Chiropractor
  • Fort Myers, FL
  • NPI 1508125311
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1962890533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 CORPORATE CT STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193539",
            "telephone_number": "239-433-1011",
            "fax_number": "239-433-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 CORPORATE CT STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193539",
            "telephone_number": "239-433-1011",
            "fax_number": "239-433-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLIS CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "239-433-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH10990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wall Anesthesia Inc.
• Kathleen Wall, CRNA
• Jordan Wallace, PHARMD
• Tasha B Wallace, D.O.
• Anthony Waller
• Deborahlee Wallis
• Kelly Wallis, D.C.
• Jaekilla Walls
• Jennifer Lynn Walls, MD
• Linda A Walls, PA C

• Chiropractor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.