Healthcare Provider Details

I. General information

NPI: 1114628286
Provider Name (Legal Business Name): PROJECT CHIRO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 FRONTIER PARK DR
O FALLON MO
63366-3963
US

IV. Provider business mailing address

2718 RED CEDAR PARC DR S
O FALLON MO
63368-6607
US

V. Phone/Fax

Practice location:
  • Phone: 636-244-2246
  • Fax:
Mailing address:
  • Phone: 636-330-0787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. CHRISTOPHER RYAN WEILANDICH
Title or Position: OWNER
Credential: DC
Phone: 636-330-0787