Provider Demographics
NPI:1710271747
Name:BERGER CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:BERGER CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-721-3838
Mailing Address - Street 1:8135 DELMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3729
Mailing Address - Country:US
Mailing Address - Phone:314-721-3838
Mailing Address - Fax:314-721-7068
Practice Address - Street 1:8135 DELMAR BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY CITY
Practice Address - State:MO
Practice Address - Zip Code:63130-3729
Practice Address - Country:US
Practice Address - Phone:314-721-3838
Practice Address - Fax:314-721-7068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty