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General NPI Number Information
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NPI Number | 1225402803
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Entity Type | Individual
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Provider Name | KATHERINE LILLEY PT
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Gender | Female
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 1575 SCOTT DR
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City | FARMVILLE
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State | VA
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Zip | 23901-2662
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Country | US
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Telephone | 434-392-8806
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Fax |
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Provider Business Mailing Address
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Address Line | 104 WATSON RD
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City | SPRINGFIELD
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State | TN
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Zip | 37172-4510
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 32336
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305209825
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11106
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License Number State | TN
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