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Individual
MR. LARRY LEE LILLEY III
Active
Individual
MR. LARRY LEE LILLEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NNP
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
Primary
0001190201
VA
Other
Enumeration date
03/14/2010
Last updated
03/14/2010
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