| Doctor Name: | MRS. TARA LOUISE LILLEMON |
| NPI Number: | 1255539714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | 23423 |
| Business Practice Address: | 3637 Sycamore Dairy Rd Fayetteville, NC - 283033415 |
| Business Phone Number: | 9104871832 |
| Business Fax Number: | 9104876950 |
| Mailing Address: | 5832 Tuckertown Ln, FAYETTEVILLE |
| State: | NC |
| Postal Code: | 283141375 |
| Phone Number: | 9043474755 |
| Fax Number: | |
| NPI Enumeration Date: | 07/06/2007 |
| NPI Last Update Date: | 01/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 23423 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |