Provider Demographics
NPI:1851500128
Name:LYLES, WILLIAM H (OTR)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:H
Last Name:LYLES
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6217 CASTLEGATE DR W
Mailing Address - Street 2:APARTMENT 1635
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8376
Mailing Address - Country:US
Mailing Address - Phone:970-946-1835
Mailing Address - Fax:303-954-0495
Practice Address - Street 1:4001 HOME ST
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-2802
Practice Address - Country:US
Practice Address - Phone:303-688-3174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1060693225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist