Provider Demographics
NPI:1649304510
Name:DR KARENS CHIROPRACTIC CENTER PC
Entity type:Organization
Organization Name:DR KARENS CHIROPRACTIC CENTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAHLMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-330-8745
Mailing Address - Street 1:134 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4303
Mailing Address - Country:US
Mailing Address - Phone:405-330-8745
Mailing Address - Fax:405-330-6616
Practice Address - Street 1:134 E 15TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4303
Practice Address - Country:US
Practice Address - Phone:405-330-8745
Practice Address - Fax:405-330-6616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK125425085Medicare ID - Type Unspecified