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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. LOREN EDGAR LILLY, RRT

Active Sole Proprietor

MR. LOREN EDGAR LILLY, RRT is a 2279P1005X healthcare provider located in MESA, Arizona. NPI 1104952043 is currently active in the NPPES registry. Verify at CMS.

2279P1005X · MESA, AZ

Registration Details

NPI Number
1104952043
Provider Type
Individual
Gender
Male
NPI Issued
Feb 26, 2007 (19.446042691444 yrs)
Last Updated
Jul 8, 2007
License
1759 (AZ)
Sole Proprietor
Yes

Practice Information

Address
6343 EAST MAIN STREET
SUITE 8
MESA, AZ, 85205
Browse AZ providers · Browse ZIP 85205
Phone
4803258838
Primary Specialty
2279P1005X
2279P1005X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.