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Individual

DOUGLAS DEAN LILL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH, CCN

Contact information

Practice address
430 RANDOLPH ST NW, WASHINGTON, DC 20011-5940
(512) 426-2894
Mailing address
430 RANDOLPH ST NW, WASHINGTON, DC 20011-5940
(512) 426-2894

Taxonomy

Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
053358-1
NY
1835N1003X
Nutrition Support Pharmacist
19342
MD
1835N1003X
Nutrition Support Pharmacist
29RI03240500
NJ
1835N1003X
Nutrition Support Pharmacist
30711
TX
1835N1003X
Nutrition Support Pharmacist
Primary
PH00000655
DC
1835N1003X
Nutrition Support Pharmacist
RP442622
PA

Other

Enumeration date
12/28/2009
Last updated
12/28/2009
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