Healthcare Provider Details
I. General information
NPI: 1629109087
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF KANSAS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8340 N BROADWAY
SAINT LOUIS MO
63147-2333
US
IV. Provider business mailing address
5080 SPECTRUM DR SUITE 1200 WEST
ADDISON TX
75001-4648
US
V. Phone/Fax
- Phone: 314-385-9563
- Fax: 214-775-4502
- Phone: 972-720-7772
- Fax: 214-775-4502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QX0100X |
| Taxonomy | Occupational Medicine Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ARTHUR
ZIPORIN
Title or Position: PRESIDENT
Credential:
Phone: 972-364-8000