MEDICARE: REBECCA GOULD KARLEN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2003017485	MO

General Provider Information

NPI Number	:	1134171507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA GOULD KARLEN DC

Provider Business Mailing Address
First Line	:	2918 SUTTON BOULEVARD
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143
Country	:	US
Telephone Number	:	314-781-0063
Fax Number	:	314-499-9044

Provider Business Practice Location Address
First Line	:	2918 SUTTON BOULEVARD
Second Line	:
City	:	MAPLEWOOD
State	:	MO
Zip	:	63143
Country	:	US
Telephone Number	:	314-781-0063
Fax Number	:	314-499-9044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/28/2024

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