Johnny Lawrence Tillis is a student in an organized health care education training program in Elk Grove, CA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Johnny Lawrence Tillis NPI is 1528606829. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
9412 BIG HORN BLVD STE 6
ELK GROVE, CA
ZIP 95758-101
Phone: (916) 879-2574
The enumeration date for this NPI number is 12/17/2019 and was last updated on 9/20/2021.