McKenzie Elyse Lillia
Physical Therapist in Lugoff, SC. Individual provider (NPI-1).
NPI number1417543158
StatusActive
Last updated in NPPESDec 16, 2020
Details
- NPI
- 1417543158
- Entity type
- Individual (NPI-1)
- Name
- McKenzie Elyse Lillia
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 16, 2020
- Certification date
- Dec 16, 2020
- Last updated
- Dec 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT.10512 | SC | Yes |
Practice location
437a Highway 601 SLugoff, SC 29078-8918
Phone 803-900-4020
Mailing address
1336 Garrison RdVineland, NJ 08360-6906
Phone 609-579-9799
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