Healthcare Provider Details

I. General information

NPI: 1821313297
Provider Name (Legal Business Name): REBECCA GOULD DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 08/28/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2918 SUTTON BOULEVARD
MAPLEWOOD MO
63143-3012
US

IV. Provider business mailing address

2918 SUTTON BOULEVARD
MAPLEWOOD MO
63143-3012
US

V. Phone/Fax

Practice location:
  • Phone: 314-781-0063
  • Fax: 314-499-9044
Mailing address:
  • Phone: 314-781-0063
  • Fax: 314-499-9044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number2003017485
License Number StateMO

VIII. Authorized Official

Name: REBECCA GOULD KARLEN
Title or Position: CEO
Credential: DC
Phone: 314-781-0063