MEDICARE: ERIKA FARMER OTR, 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	2006012228	MO
2	225X00000X	Occupational Therapist	2007004043	MO

General Provider Information

NPI Number	:	1174538516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA FARMER OTR, DC

Provider Business Mailing Address
First Line	:	1004 CHARTRES AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63132-4016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5626 W FLORISSANT AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63120-2440
Country	:	US
Telephone Number	:	314-381-6300
Fax Number	:

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	11/21/2011

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