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Organization
VITAL PERFORMANCE LLC
Active
Organization
VITAL PERFORMANCE LLC
Active
Other names
Vital Performance Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN CHARLES JEROME BOSSON DC (DOCTOR/OWNER)
(636) 486-6933
Entity
Organization
Contact information
Practice address
7827 HIGHWAY N STE 102, DARDENNE PRAIRIE, MO 63368-7199
(636) 486-6933
Mailing address
7827 HIGHWAY N, #102, DARDENNE PRAIRIE, MO 63368
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2017015434
MO
Other
Enumeration date
09/19/2017
Last updated
09/19/2017
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