MEDICARE: KARI A BAKERIS D.C.

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	06627	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	35343	OTHER	IA	BCBS

General Provider Information

NPI Number	:	1215931241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI A BAKERIS D.C.

Provider Business Mailing Address
First Line	:	2411 CORAL CT
Second Line	:	STE 3
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2878
Country	:	US
Telephone Number	:	319-545-4444
Fax Number	:	319-545-4445

Provider Business Practice Location Address
First Line	:	2411 CORAL CT
Second Line	:	STE 3
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2878
Country	:	US
Telephone Number	:	319-545-4444
Fax Number	:	319-545-4445

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/08/2007

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