MEDICARE: DAKOTA VEST DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2025054039	MO

General Provider Information

NPI Number	:	1871436915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAKOTA VEST DC

Provider Business Mailing Address
First Line	:	12977 N 40 DR STE 309
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-8654
Country	:	US
Telephone Number	:	636-746-0008
Fax Number	:

Provider Business Practice Location Address
First Line	:	12977 N 40 DR STE 309
Second Line	:
City	:	CREVE COEUR
State	:	MO
Zip	:	63141-8654
Country	:	US
Telephone Number	:	636-746-0008
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ DAKOTA VEST DC” Practice Location

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