Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2005000397 | MO |
NPI | 1629139688 |
---|---|
Provider Name | Dr. Elizabeth Louise Blair |
First Address | Kansas City, MO 64111-1932 |
Second Address | Kansas City, MO 64111-1932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 19/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1196322 | AETNA HMO (01) | MO |
277729 | COVENTRY (01) | MO |
36591032 | BLUE CROSS BLUE SHIELD (01) | MO |
694678 | ACN (01) | MO |
7854791 | AETNA PPO (01) | MO |
V08957 | (02) | MO |