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St. Louis Optimal Performance, LLC

Chiropractor in Chesterfield, MO. Organization (NPI-2).

NPI number1245574367
StatusActive
Last updated in NPPESJul 2, 2013

Details

NPI
1245574367
Entity type
Organization (NPI-2)
Legal business name
St. Louis Optimal Performance, LLC
Organization subpart
Yes
Enumeration date
Nov 15, 2012
Last updated
Jul 2, 2013

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor2012014238MOYes

Other names

  • Optimal Performance Center (Doing Business As)

Practice location

219 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257

Phone 636-778-9997 · Fax 636-778-9994

Mailing address

219 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257

Phone 636-778-9997 · Fax 636-778-9994

Authorized official

Brian Andrew Laiderman
Chiropractic Physician/Owner
6367789997

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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