Individual
DR. JAN C LILES
Active
Individual
DR. JAN C LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D
Taxonomy
Speciality
Code
Description
License number
State
231HA2500X
Assistive Technology Supplier Audiologist
Primary
695A
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009978130
—
AL
01
—
51506305LIL
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/06/2007
Last updated
10/03/2011
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