Individual
MS. MELISSA DAWN LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
122 12TH STREET EXT, PRINCETON, WV 24740-2352
(304) 487-7275
Mailing address
112 12TH ST, PRINCETON, WV 24740-2312
(304) 254-3131
(304) 254-3172
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
733
WV
363AM0700X
Medical Physician Assistant
Primary
463
WV
Other
Enumeration date
05/06/2008
Last updated
10/20/2017
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