Individual
MR. THOMAS JOSHUA LILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPAM, MED, PA-C, ATC
Contact information
Practice address
46 WESLEY RD, DALEVILLE, VA 24083-3082
(540) 591-9440
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126001826
VA
363A00000X
Physician Assistant
Primary
0110008846
VA
363A00000X
Physician Assistant
029349
NY
Other
Enumeration date
02/09/2015
Last updated
11/12/2024
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