Individual
OTIS D LYLES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 LYNN DR, ALTON, IL 62002-7508
(314) 581-7735
(618) 466-5501
Mailing address
305 LYNN DR, ALTON, IL 62002-7508
(314) 581-7735
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
MO
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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