Individual
JUSTIN TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 251-2067
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 251-2067
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06938
NC
Other
Enumeration date
01/05/2017
Last updated
01/05/2017
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