Healthcare Provider Details

I. General information

NPI: 1386274629
Provider Name (Legal Business Name): SARAH-JANE PAVLIK TRAUTWEIN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

IV. Provider business mailing address

2845 VETERANS MEMORIAL PKWY
SAINT CHARLES MO
63303-3526
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-6988
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number038013540
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2020002619
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: