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Individual

TRAYLA LILES I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1698 BURTONVILLE RD, TOLLESBORO, KY 41189-8749
(606) 202-3061
Mailing address
1698 BURTONVILLE RD, TOLLESBORO, KY 41189-8749

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002313A
IN

Other

Enumeration date
12/01/2014
Last updated
12/01/2014
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