Individual
NATHAN ROBERT LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
45 E STATE ST, FARMINGTON, UT 84025-2344
(801) 402-5261
Mailing address
45 E. STATE STREET, FARMINGTON, UT 84025
(801) 971-0545
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
10263070-4102
UT
Other
Enumeration date
01/17/2023
Last updated
10/29/2024
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