Individual
KARL LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
42340
CO
Other
Enumeration date
08/09/2020
Last updated
08/09/2020
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