Provider Demographics
NPI:1831250968
Name:LILES THERAPY INC.
Entity type:Organization
Organization Name:LILES THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LILES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:903-276-6012
Mailing Address - Street 1:1417 ROLLING RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-9036
Mailing Address - Country:US
Mailing Address - Phone:903-276-6012
Mailing Address - Fax:870-773-9869
Practice Address - Street 1:1417 ROLLING RIDGE CIR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-9036
Practice Address - Country:US
Practice Address - Phone:903-276-6012
Practice Address - Fax:870-773-9869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty