Provider Demographics
NPI:1235281775
Name:BUERGER TALACKA, KAREN M (DC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:BUERGER TALACKA
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 117
Mailing Address - Street 2:
Mailing Address - City:SWEET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18656
Mailing Address - Country:US
Mailing Address - Phone:570-477-2158
Mailing Address - Fax:570-477-2433
Practice Address - Street 1:5317 MAIN ROAD
Practice Address - Street 2:
Practice Address - City:SWEET VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18656
Practice Address - Country:US
Practice Address - Phone:570-477-2158
Practice Address - Fax:570-477-2433
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003568L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA440061Other1ST PRIORITY HEALTH
PA1031192OtherASHN
089352Medicare ID - Type Unspecified
PA1031192OtherASHN