Provider Demographics
NPI:1871331264
Name:LILLIE, CLARE (PTA)
Entity type:Individual
Prefix:
First Name:CLARE
Middle Name:
Last Name:LILLIE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 W 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3305
Mailing Address - Country:US
Mailing Address - Phone:203-979-9643
Mailing Address - Fax:
Practice Address - Street 1:8550 E LOWRY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6932
Practice Address - Country:US
Practice Address - Phone:303-676-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant