Provider Demographics
NPI:1871743013
Name:CADDELL, KARIN M (DC)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:M
Last Name:CADDELL
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 1:278 DEWDROP LANE
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:MO
Mailing Address - Zip Code:65757
Mailing Address - Country:US
Mailing Address - Phone:417-736-4443
Mailing Address - Fax:417-736-4443
Practice Address - Street 1:278 DEWDROP LANE
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:MO
Practice Address - Zip Code:65757
Practice Address - Country:US
Practice Address - Phone:417-736-4443
Practice Address - Fax:417-736-4443
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE 004315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor