Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2008027068 | MO |
NPI | 1003124173 |
---|---|
Provider Name | Martha A Kaeser |
First Address | Chesterfield, MO 63017-5529 |
Second Address | Chesterfield, MO 63017-5529 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2010 |
Last Update Date | 18/07/2012 |