Organization
BODY DYNAMICS CHIROPRACTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M. VIFQUAIN D.C. (PRESIDENT)
(816) 524-7000
Entity
Organization
Contact information
Practice address
319 SE MAIN ST, LEES SUMMIT, MO 64063-2333
(816) 524-7000
(816) 524-6993
Mailing address
319 SE MAIN ST, LEES SUMMIT, MO 64063-2333
(816) 524-7000
(816) 524-6993
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
CE6088
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18786011
BCBS
MO
01
—
U44965
HUMANA
MO
Enumeration date
05/30/2007
Last updated
07/17/2008
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