Organization
RIVERSIDE BREAST SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY J LILLY MD (PRESIDENT)
(614) 262-9922
Entity
Organization
Contact information
Practice address
3555 OLENTANGY RIVER RD, SUITE 2020, COLUMBUS, OH 43214-3912
(614) 262-9922
(614) 262-9927
Mailing address
3555 OLENTANGY RIVER RD, SUITE 2020, COLUMBUS, OH 43214-3912
(614) 262-9922
(614) 262-9927
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35-03-9979-L
OH
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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