Provider Demographics
NPI:1023062882
Name:JACOBSON, KAREN ROSE (DC)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ROSE
Last Name:JACOBSON
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 1:9160 E SHEA BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6700
Mailing Address - Country:US
Mailing Address - Phone:480-657-3600
Mailing Address - Fax:480-657-9991
Practice Address - Street 1:9160 E SHEA BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6700
Practice Address - Country:US
Practice Address - Phone:480-657-3600
Practice Address - Fax:480-657-9991
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5722111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ27327Medicare ID - Type Unspecified