Jesse Lilly

NPI #1417588773 in Athens, West Virginia

Provider Information

NPI Number: 1417588773
Entity Type: Individual
Name: Jesse Lilly
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jan 27, 2020
Last Updated: Jan 27, 2020

Practice Location

Address: 1000 VERMILLION ST
City: Athens
State: West Virginia
ZIP Code: 24712-9027
Phone: (304) 322-6264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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