Provider Demographics
NPI:1972679595
Name:LILLARD CHIROPRACTIC PA
Entity Type:Organization
Organization Name:LILLARD CHIROPRACTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:STEWART
Authorized Official - Last Name:LILLARD
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:423-507-8305
Mailing Address - Street 1:105 ELIZABETH
Mailing Address - Street 2:SUITE 39
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303
Mailing Address - Country:US
Mailing Address - Phone:423-507-8305
Mailing Address - Fax:423-507-8333
Practice Address - Street 1:105 ELIZABETH
Practice Address - Street 2:SUITE 39
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303
Practice Address - Country:US
Practice Address - Phone:423-507-8305
Practice Address - Fax:423-507-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty