Individual
ANTHONY N LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9227 ELLISON RIDGE RD, JUMPING BRANCH, WV 25969-6097
(304) 466-4237
Mailing address
9227 ELLISON RIDGE RD, JUMPING BRANCH, WV 25969-6097
(304) 466-4237
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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