Provider Demographics
NPI:1821120296
Name:OFFNER, LISA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANN
Last Name:OFFNER
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 1:37955 S CAMINO BLANCO RD
Mailing Address - Street 2:
Mailing Address - City:WICKENBURG
Mailing Address - State:AZ
Mailing Address - Zip Code:85390-3402
Mailing Address - Country:US
Mailing Address - Phone:928-231-7025
Mailing Address - Fax:
Practice Address - Street 1:37955 S CAMINO BLANCO RD
Practice Address - Street 2:
Practice Address - City:WICKENBURG
Practice Address - State:AZ
Practice Address - Zip Code:85390-3402
Practice Address - Country:US
Practice Address - Phone:928-231-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor