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General NPI Number Information
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NPI Number | 1093801953
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Entity Type | Organization
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Legal Business Name | THE WORK PERFORMANCE CENTER, INC.
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4017 S CLOVERLEAF DR
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City | SAINT PETERS
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State | MO
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Zip | 63376-6450
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Country | US
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Telephone | 636-928-6114
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Fax | 636-928-6568
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Provider Business Mailing Address
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Address Line | 4017 S CLOVERLEAF DR
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City | SAINT PETERS
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State | MO
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Zip | 63376-6450
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Country | US
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Telephone | 636-928-6114
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Fax | 636-928-6568
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUZANNE E WAGAR-HARRIS
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Credential | P.T.
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Telephone | 636-928-6114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00801
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License Number State | MO
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