Individual
KEVIN TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
1803 FOREST HILLS ROAD, WILSON, NC 27893
(252) 243-9629
(252) 243-0915
Mailing address
PO BOX 3148, WILSON, NC 27895-3148
(252) 243-9629
(252) 243-0915
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3353
NC
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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