Individual
MRS. CHRYSTIA CLARK LILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 625-4400
Mailing address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
58619
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2010
Last updated
08/07/2023
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