Provider Demographics
NPI:1003838350
Name:BAADER, KAREN REESE (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:REESE
Last Name:BAADER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1364
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24007-1364
Mailing Address - Country:US
Mailing Address - Phone:540-966-1423
Mailing Address - Fax:540-966-4125
Practice Address - Street 1:41 SUMMERS WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-8291
Practice Address - Country:US
Practice Address - Phone:540-966-1423
Practice Address - Fax:540-966-4125
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA281806OtherANTHEM BLUE CROSS
VA4579046OtherAETNA