Individual
MRS. KYLA LYNN TILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3812 NW MEADOWBROOK DR, LAWTON, OK 73505-4952
(580) 574-5811
Mailing address
3812 NW MEADOWBROOK DR, LAWTON, OK 73505-4952
(580) 574-5811
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2018
OK
Other
Enumeration date
12/19/2023
Last updated
12/19/2023
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