MR. John Gerard Lillo, PA
NPI #1790972644 in Grants, New Mexico
Provider Information
- NPI Number
- 1790972644
- Entity Type
- Individual
- Name
- MR. John Gerard Lillo, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- Sep 25, 2007
- Last Updated
- Sep 25, 2007
Practice Location
- Address
- LOBO CANYON RD
- Address 2
- WESTERN NEW MEXICO CORRECTIONS
- City
- Grants
- State
- New Mexico
- ZIP Code
- 87020-0250
- Phone
- (505) 876-8360
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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