Cameron Matthew Lilly
Specialist/Technologist, Athletic Trainer in Smyrna, GA. Individual provider (NPI-1).
NPI number1144992157
StatusActive
Last updated in NPPESFeb 9, 2025
Details
- NPI
- 1144992157
- Entity type
- Individual (NPI-1)
- Name
- Cameron Matthew Lilly
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 29, 2021
- Certification date
- Feb 9, 2025
- Last updated
- Feb 9, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT004362 | GA | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT001826 | WV |
Practice location
1836 Roswell St Se Apt 2104Smyrna, GA 30080-2249
Phone 614-867-6991
Mailing address
1836 Roswell St Se Apt 2104Smyrna, GA 30080-2249
Phone 614-867-6991
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