Individual
TAYLOR RAVOYD LILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
(907) 377-6631
Mailing address
2630 CENTRAL AVE, EIELSON AFB, AK 99702-2301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1377738
TX
225100000X
Physical Therapist
174385
AK
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/13/2021
Last updated
09/12/2024
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