MEDICARE: MEDWORK LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center	1613078	OH

General Provider Information

NPI Number	:	1437377637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDWORK LLC

Provider Business Mailing Address
First Line	:	1435 CINCINNATI ST
Second Line	:	SUITE 100
City	:	DAYTON
State	:	OH
Zip	:	45417-4614
Country	:	US
Telephone Number	:	937-449-0800
Fax Number	:	937-449-0881

Provider Business Practice Location Address
First Line	:	1435 CINCINNATI ST
Second Line	:	SUITE 100
City	:	DAYTON
State	:	OH
Zip	:	45417-4614
Country	:	US
Telephone Number	:	937-449-0800
Fax Number	:	937-449-0881

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEAN E IMBROGNO
Credential	:	MD
Telephone Number	:	937-449-0800

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	04/02/2015

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Directions to “MEDWORK LLC ” Practice Location

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