Individual
JULIA LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4551 8TH ST S, WISCONSIN RAPIDS, WI 54494-6781
(715) 423-1340
Mailing address
2927 GEORGE RD APT 101, WISCONSIN RAPIDS, WI 54495-3272
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4005-35
WI
Other
Enumeration date
06/10/2024
Last updated
06/10/2024
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