Individual
MRS. KLAYE LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 SULLIVAN RD, GLEN MORGAN, WV 25813-7600
(304) 256-4555
Mailing address
136 SULLIVAN RD, GLEN MORGAN, WV 25813-7600
(304) 256-4555
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
000230
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156315000
—
WV
Enumeration date
03/06/2008
Last updated
03/06/2008
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