Provider Demographics
NPI:1720492531
Name:ELIAS, OLIVIA (DC LLC)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:ELIAS
Suffix:
Gender:F
Credentials:DC LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 NE WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-8477
Mailing Address - Country:US
Mailing Address - Phone:816-272-3559
Mailing Address - Fax:816-272-1594
Practice Address - Street 1:1332 NE WINDSOR DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-8477
Practice Address - Country:US
Practice Address - Phone:816-272-3559
Practice Address - Fax:816-272-1594
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013033224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor