MEDICARE: DR. KAREN ANN BOABK 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	X-004787	NY

General Provider Information

NPI Number	:	1952450199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN ANN BOABK D.C.

Provider Business Mailing Address
First Line	:	1340 LAKE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14613-1244
Country	:	US
Telephone Number	:	585-254-8020
Fax Number	:	585-254-7370

Provider Business Practice Location Address
First Line	:	1340 LAKE AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14613-1244
Country	:	US
Telephone Number	:	585-254-8020
Fax Number	:	585-254-7370

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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