Individual
BRANDON LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 20TH ST, SUITE 205, HUNTINGTON, WV 25703-2071
(304) 691-1500
(304) 691-1510
Mailing address
1115 20TH ST, SUITE 205, HUNTINGTON, WV 25703-2071
(304) 691-1500
(304) 691-1510
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
82101
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2015
Last updated
01/04/2022
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