Individual
CORLETTIA ANN LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
140 WAYCROSS CT, COOL RIDGE, WV 25825
(681) 264-0353
Mailing address
PO BOX 186, COOL RIDGE, WV 25825-0186
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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