Provider Demographics
NPI:1831137553
Name:PURVIS, LILLIAN LINNELL (DC)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:LINNELL
Last Name:PURVIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 SYCAMORE MEWS CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-4375
Mailing Address - Country:US
Mailing Address - Phone:804-378-1119
Mailing Address - Fax:
Practice Address - Street 1:3076 STONY POINT RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-2349
Practice Address - Country:US
Practice Address - Phone:804-323-1589
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556152111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00V5897P19Medicare ID - Type Unspecified
VAU96663Medicare UPIN