Organization
LILY WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN BEESON (PRESIDENT)
(952) 435-2661
Entity
Organization
Contact information
Practice address
1601 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7013
(952) 435-2661
Mailing address
1601 SOUTHCROSS DR W, BURNSVILLE, MN 55306-7013
(952) 435-2661
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CFM02120
MN
Other
Enumeration date
03/22/2010
Last updated
03/22/2010
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