Provider Demographics
NPI:1124299268
Name:DANIEL P. LILLEY, INC
Entity type:Organization
Organization Name:DANIEL P. LILLEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERIOR PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:LILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-522-6774
Mailing Address - Street 1:800 COMPTON RD
Mailing Address - Street 2:UNIT 3
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-3826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 COMPTON RD
Practice Address - Street 2:UNIT 3
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3826
Practice Address - Country:US
Practice Address - Phone:513-522-6774
Practice Address - Fax:513-522-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT002125261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000010906OtherANTHEM
OH64 00298OtherUNITED HEALTH CARE
OHPT 147OtherHUMANA
OH0756651Medicare PIN