Healthcare Provider Details

I. General information

NPI: 1063603140
Provider Name (Legal Business Name): THE WORK CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PEACH CT SUITE H
COLUMBIA MO
65203-3800
US

IV. Provider business mailing address

111 WESTPORT PLZ SUITE 1100
SAINT LOUIS MO
63146-3011
US

V. Phone/Fax

Practice location:
  • Phone: 573-256-8100
  • Fax: 573-256-8104
Mailing address:
  • Phone: 314-434-2885
  • Fax: 314-576-1006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL FALLWELL
Title or Position: OWNER/PRESIDENT
Credential: OTR/L
Phone: 314-434-2886