Provider Demographics
NPI:1316738974
Name:VITAL CHIROPRACTIC LLC
Entity type:Organization
Organization Name:VITAL CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:M
Authorized Official - Last Name:GABLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:636-697-7976
Mailing Address - Street 1:1 AMBER GRAIN CT
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8052
Mailing Address - Country:US
Mailing Address - Phone:636-339-1100
Mailing Address - Fax:636-339-1115
Practice Address - Street 1:7118 SOUTH OUTER ROAD 364
Practice Address - Street 2:
Practice Address - City:O'FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368
Practice Address - Country:US
Practice Address - Phone:636-339-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty