Dynamic Life Chiropractic, LLC

NPI #1508125303 in O Fallon, Missouri

Provider Information

NPI Number: 1508125303
Entity Type: Organization
Organization Name: Dynamic Life Chiropractic, LLC
Primary Specialty: Chiropractor
Enumeration Date: May 14, 2012
Last Updated: May 14, 2012

Practice Location

Address: 2161 W TERRA LN
City: O Fallon
State: Missouri
ZIP Code: 63366-2366
Phone: (636) 887-9003

Authorized Official

Name: MRS. KRISTIN E. GAINES-PORLIER, D.C.
Title: OWNER/DOCTOR
Phone: (618) 213-6886

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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