Search › Illinois › 343900000X
Otis Lyles
NPI 1609439272 · on the registry since 2019 · sole proprietor
Practice
- Address
- 305 Lynn Dr
Alton, IL 62002 - Phone
- (314) 581-7735
- Fax
- (618) 466-5501
Additional practice sites
- 1999 Old Jamestown Rd, Florissant, MO
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-04-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois