Provider Demographics
NPI:1205872728
Name:KRAHL, KAREN J (DC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:KRAHL
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 1:628 CALIFORNIA BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2548
Mailing Address - Country:US
Mailing Address - Phone:805-544-6846
Mailing Address - Fax:805-544-3711
Practice Address - Street 1:628 CALIFORNIA BLVD STE E
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2548
Practice Address - Country:US
Practice Address - Phone:805-544-6846
Practice Address - Fax:805-544-3711
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-22
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT04768Medicare UPIN
CAWDC12451AMedicare ID - Type Unspecified