Individual
MR. LONNIE LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
8075 DELAROCHE DR, JACKSONVILLE, FL 32210
(352) 281-3834
Mailing address
8075 DELAROCHE DR, JACKSONVILLE, FL 32210-2408
(352) 281-3834
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12434
FL
Other
Enumeration date
02/15/2013
Last updated
02/15/2013
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