Provider Demographics
NPI:1275766628
Name:RICKER, CAROLINE C (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:C
Last Name:RICKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:C
Other - Last Name:MENOUSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:10807 BIG BEND RD
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-6054
Mailing Address - Country:US
Mailing Address - Phone:314-269-3847
Mailing Address - Fax:
Practice Address - Street 1:10807 BIG BEND RD
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6054
Practice Address - Country:US
Practice Address - Phone:314-269-3847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009026115111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor