Individual
DR. JARED T. LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
238 W MAIN ST, LENA, IL 61048-9770
(815) 369-4974
Mailing address
238 W MAIN ST, P.O. BOX 424, LENA, IL 61048-9770
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011548
IL
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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