Individual
MANDY LILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3304 E. I80 SERVICE RD, CHEYENNE, WY 82009
(307) 274-2646
Mailing address
3304 E. I80 SERVICE RD, CHEYENNE, WY 82009
(307) 274-2646
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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