Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH11224 | FL |
NPI | 1003221268 |
---|---|
Provider Name | Dr. William Lewis Bevis |
First Address | Tallahassee, FL 32303-5293 |
Second Address | Tallahassee, FL 32303-5293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 31/12/2014 |