Individual
ALIX RAE LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
245 THOMAS AVE, DAVIS, WV 26260
(304) 668-1198
Mailing address
PO BOX 63, DAVIS, WV 26260-0063
(304) 668-1198
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1027
WV
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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