Individual
AMANDA LEE TILLERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1006 COUNTY ROAD 1445, SULPHUR SPRINGS, TX 75482-9129
(903) 243-4143
Mailing address
PO BOX 391, SULPHUR SPRINGS, TX 75483-0391
(903) 243-4143
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
195653
TX
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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