Provider Demographics
NPI:1053178665
Name:LILLIE, LUCY LEE SYVERSON (DC)
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:LEE SYVERSON
Last Name:LILLIE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3198 COUNTRY PARK DR
Mailing Address - Street 2:
Mailing Address - City:TODDVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52341-9728
Mailing Address - Country:US
Mailing Address - Phone:319-560-3316
Mailing Address - Fax:
Practice Address - Street 1:1212 DINA CT
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-4706
Practice Address - Country:US
Practice Address - Phone:319-560-3316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA125049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor