Individual
LILLIE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
23000 MOAKLEY ST STE 102, LEONARDTOWN, MD 20650-2916
(301) 475-5555
(301) 475-8535
Mailing address
23000 MOAKLEY ST STE 102, LEONARDTOWN, MD 20650-2916
(301) 475-8535
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6239
MD
Other
Enumeration date
08/13/2026
Last updated
08/13/2026
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