Provider Demographics
NPI:1164896999
Name:SPITLER - LILLEY, LLC
Entity Type:Organization
Organization Name:SPITLER - LILLEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEWEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPITLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-227-2476
Mailing Address - Street 1:1781 E. STATE RTE 69
Mailing Address - Street 2:SUITE 65
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301
Mailing Address - Country:US
Mailing Address - Phone:928-227-2476
Mailing Address - Fax:
Practice Address - Street 1:1781 E. STATE RTE 69
Practice Address - Street 2:SUITE 65
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301
Practice Address - Country:US
Practice Address - Phone:928-227-2476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD8219237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty