Organization
GENESIS CHIROPRACTIC, LLC
Active
Other names
ProActive Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYNETTE RENEE MAYFIELD DC (OWNER)
(314) 210-2623
Entity
Organization
Contact information
Practice address
1520 PARKWAY W, FESTUS, MO 63028-2381
(636) 937-0100
Mailing address
101 RICHARDSON XING, ARNOLD, MO 63010-6006
(314) 210-2623
(636) 464-2180
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2001008726
MO
Other
Enumeration date
08/02/2018
Last updated
01/16/2019
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