# LILLIBONN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Health Source of Boardman
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972189207
- **Authorized official:** ASHLEY ELIZABETH RICE DC (OWNER)
- **Authorized official phone:** (334) 318-7307

## Contact information

- **Practice address:** 6775 APPLEWOOD BLVD, BOARDMAN, OH 44512-4940
- **Practice address phone:** (330) 758-2353
- **Practice address fax:** (330) 758-9733
- **Mailing address:** 6775 APPLEWOOD BLVD, BOARDMAN, OH 44512-4940
- **Mailing address phone:** (330) 758-2353
- **Mailing address fax:** (330) 758-9733

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 03/18/2021
- **Last updated:** 08/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | LICENSE | DC05023 | OH |