Individual ProviderChad C WillisChiropractorChiropractic ProvidersPractice Address1565 E Leighfield Dr Ste 150, Meridian, ID 83646-5371(208) 855-0585(208) 602-1573PECOS EnrollmentBased on the most recent information from CMS, provider Chad C Willis does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1053598599Provider TypeIndividualFull NameWillis, Chad CCredentialD.C.GenderMaleSole ProprietorYesEnumeration Date1/28/2008Last Updated1/28/2008Contact InformationPractice LocationPractice Address1565 E Leighfield Dr Ste 150, Meridian, ID 83646-5371Phone(208) 855-0585FaxUnlisted FaxMailing LocationMailing Address12224 W Bowmont St, Boise, ID 83713-0021Phone(208) 602-1573FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseCHIA-1267Idaho