Healthcare Provider Details

I. General information

NPI: 1700800364
Provider Name (Legal Business Name): ADVANCE MEDICAL SERVICES WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 WHITTIER ST THE WELLNESS CENTER
SAINT LOUIS MO
63113-2957
US

IV. Provider business mailing address

2601 WHITTIER ST THE WELLNESS CENTER
SAINT LOUIS MO
63113-2957
US

V. Phone/Fax

Practice location:
  • Phone: 314-535-4040
  • Fax: 314-535-4041
Mailing address:
  • Phone: 314-535-4040
  • Fax: 314-535-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARCIA HILTON-KYER
Title or Position: CFO
Credential: MBA
Phone: 314-535-4040