Provider Type Icon

DYNAMIC LIFE CHIROPRACTIC LLC NPI 1508125303


NPI Information

NPI: 1508125303
Provider Name: DYNAMIC LIFE CHIROPRACTIC, LLC

Doing Business As: LAKE ST. LOUIS CHIROPRACTIC

Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
2161 W TERRA LN
O FALLON, MO
ZIP 63366
Phone: (636) 887-9003
Get Directions

DYNAMIC LIFE CHIROPRACTIC, LLC is a chiropractor in O Fallon, MO. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. DYNAMIC LIFE CHIROPRACTIC, LLC NPI is 1508125303. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Lake St. Louis Chiropractic.

The provider's business location address is:

2161 W TERRA LN
O FALLON, MO
ZIP 63366-366
Phone: (636) 887-9003
Fax: (888) 528-5527

The provider's authorized official is Kristin E. Gaines-porlier .
The authorized official title is Owner/doctor and has the following contact phone number (618) 213-6886.

The enumeration date for this NPI number is 5/14/2012 and was last updated on 5/14/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorMISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.