Provider Information for 1619953155
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LANE DOUBENMIER MILLER MA
Other Names:Former Name:LANE' DOUBENMIERSex: Female
NPI: 1619953155
Last Updated: 2015-05-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1619953155 | ||||||||
| Enumeration Date | 2005-12-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 200 MAIN ST APT. 211 KANSAS CITY, MO 64105-1277 United States Phone: 816-604-8598 | Fax: | ||||||||
| Primary Practice Address | 8801 E 63RD ST SUITE 104 RAYTOWN, MO 64133-4875 United States Phone: 816-368-2000 | Fax:816-533-6873 | ||||||||
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