Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 004731 | MO |
NPI | 1598814832 |
---|---|
Provider Name | Lillian Lee Avner |
First Address | Kansas City, MO 64133-2026 |
Second Address | Kansas City, MO 64133-2026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 08/07/2007 |