Individual
GEORGE ARTHUR LILLY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1503 STUART AVE, ALBANY, GA 31707-1809
(229) 255-4558
(229) 405-3507
Mailing address
1503 STUART AVE, ALBANY, GA 31707-1809
(229) 255-4558
(229) 405-3507
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057883195
DRIVERS LICENSE NUMBER
GA
Enumeration date
12/09/2020
Last updated
12/09/2020
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