Individual
LILLYAN RUTH MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 IRVING ST NW, WASHINGTON, DC 20010-2921
(202) 996-9724
Mailing address
944 OLD STAGE RD, GROTON, NY 13073-9422
(607) 345-4014
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2024
Last updated
05/30/2024
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