Provider Demographics
NPI:1396382115
Name:BURGER, CAREY L (LAC, MSAOM, BSTCM)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:L
Last Name:BURGER
Suffix:
Gender:F
Credentials:LAC, MSAOM, BSTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 NOTTINGHAM AVE APT 2W
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2793
Mailing Address - Country:US
Mailing Address - Phone:314-337-2248
Mailing Address - Fax:
Practice Address - Street 1:1045 S BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1605
Practice Address - Country:US
Practice Address - Phone:314-337-2248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-01
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022009571171100000X
MDUO2305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist