Most Relevant Information
Provider Data
| NPI Number: | 1003521709 |
| Provider Name: | NATHAN ROBERT LILLY CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 10263070-4102 |
Most Important Dates
| Enumeration Date: | 01/17/2023 |
| Last Updated: | 10/29/2024 |
Provider Practice Location
45 E STATE ST
FARMINGTON
UT
840252344
Practice Location Phone/Fax
| Phone: | 8014025261 |
| Fax: |
Provider Mailing Location
45 E. STATE STREET
FARMINGTON
UT
84025
Provider Mailing Phone/Fax
| Phone: | 8019710545 |
| Fax: |