Provider Demographics
NPI:1619011558
Name:LILLY, NOEL ARTHUR (MS AT,C)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:ARTHUR
Last Name:LILLY
Suffix:
Gender:M
Credentials:MS AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38 PAHLHURST CT
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-7625
Mailing Address - Country:US
Mailing Address - Phone:304-863-5810
Mailing Address - Fax:
Practice Address - Street 1:200 TRACY WAY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-1258
Practice Address - Country:US
Practice Address - Phone:304-388-4900
Practice Address - Fax:304-388-4910
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer