Provider Demographics
NPI:1598814832
Name:AVNER, LILLIAN LEE (DC)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:LEE
Last Name:AVNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 BLUE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-2026
Mailing Address - Country:US
Mailing Address - Phone:816-699-9385
Mailing Address - Fax:
Practice Address - Street 1:4307 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133-2026
Practice Address - Country:US
Practice Address - Phone:816-699-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004731111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic