MEDICARE: KAREN A. BERGMAN

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	006780	MO

General Provider Information

NPI Number	:	1265612253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN A. BERGMAN

Provider Business Mailing Address
First Line	:	4717 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2720
Country	:	US
Telephone Number	:	314-352-0834
Fax Number	:	314-351-6411

Provider Business Practice Location Address
First Line	:	4717 HAMPTON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2720
Country	:	US
Telephone Number	:	314-352-0834
Fax Number	:	314-351-6411

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. KAREN BERGMAN ANN BERGMAN
Credential	:	D.C.
Telephone Number	:	314-352-0834

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	07/17/2013

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