Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1999137754 | MO |
NPI | 1003034430 |
---|---|
Provider Name | Dr. Tracey Katherine Cain |
First Address | Saint Louis, MO 63126-3552 |
Second Address | Saint Louis, MO 63126-3552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 24/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
128079 | BCBS PROVIDER (01) | MO |
430021 | HEALTHLINK PROVIDER (01) | MO |
44-00151 | UNITED HEALTH CARE PROVID (01) | MO |
469330 | ANTHEM PROVIDER (01) | MO |
7245095 | AETNA PROVIDER (01) | MO |
U79487 | (02) | MO |