Provider Demographics
NPI:1699147504
Name:LILLY, MARGARET (LAC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LILLY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-4344
Mailing Address - Country:US
Mailing Address - Phone:301-906-6366
Mailing Address - Fax:
Practice Address - Street 1:10723 COLUMBIA PIKE STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4445
Practice Address - Country:US
Practice Address - Phone:301-754-3730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist