Provider Demographics
NPI:1932384278
Name:KILIAN, AMANDA MAE (DC)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MAE
Last Name:KILIAN
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 1:3701 S HARVARD AVE STE D
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2282
Mailing Address - Country:US
Mailing Address - Phone:918-938-6801
Mailing Address - Fax:
Practice Address - Street 1:3701 S HARVARD AVE STE D
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2282
Practice Address - Country:US
Practice Address - Phone:918-938-6801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-06
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor