Individual
BRIAN R LILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
470 E BULLOCH ST, WASHINGTON, UT 84780-1774
(208) 473-6880
Mailing address
470 E BULLOCH ST, WASHINGTON, UT 84780-1774
(208) 473-6880
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
12435793
UT
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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