Provider Demographics
NPI:1003281163
Name:BATY, LILLY PEARL (LMT)
Entity Type:Individual
Prefix:
First Name:LILLY
Middle Name:PEARL
Last Name:BATY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1215
Mailing Address - Country:US
Mailing Address - Phone:541-631-1538
Mailing Address - Fax:
Practice Address - Street 1:485 E MAIN ST
Practice Address - Street 2:SUITE 06
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-2162
Practice Address - Country:US
Practice Address - Phone:541-631-1538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2325225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist