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General NPI Number Information
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NPI Number | 1811834385
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Entity Type | Organization
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Legal Business Name | DYNAMIC REHAB
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 10435 CLAYTON RD STE 120
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2930
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Country | US
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Telephone | 314-432-2329
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Fax |
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Provider Business Mailing Address
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Address Line | 10435 CLAYTON RD STE 120
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City | SAINT LOUIS
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State | MO
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Zip | 63131-2930
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Country | US
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Telephone | 314-432-2329
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | PARKER GRUNDMAN
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Credential | DC
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Telephone | 810-434-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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