Individual
MRS. COLLEEN MARIE LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25401-9990
(304) 263-0811
Mailing address
510 BUTLER AVENUE, MARTINSBURG, WV 25405
(304) 271-8919
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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