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General NPI Number Information
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NPI Number | 1316266612
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Entity Type | Organization
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Legal Business Name | CAROLINE MENOUSEK LLC
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 10807 BIG BEND RD
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City | KIRKWOOD
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State | MO
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Zip | 63122-6054
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Country | US
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Telephone | 314-269-3847
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Fax | 314-909-1605
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Provider Business Mailing Address
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Address Line | 10807 BIG BEND RD
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City | KIRKWOOD
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State | MO
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Zip | 63122-6054
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Country | US
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Telephone | 314-269-3847
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Fax | 314-909-1605
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROLINE C MENOUSEK
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Credential | DC
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Telephone | 314-269-3847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2009026115
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License Number State | MO
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