Provider Demographics
NPI:1619070810
Name:WORK & REHAB LLC
Entity Type:Organization
Organization Name:WORK & REHAB LLC
Other - Org Name:WORK & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAIN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:KLOSTERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:325-665-3860
Mailing Address - Street 1:2526 CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-6216
Mailing Address - Country:US
Mailing Address - Phone:325-665-3860
Mailing Address - Fax:325-793-3579
Practice Address - Street 1:2526 CRESTLINE DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-6216
Practice Address - Country:US
Practice Address - Phone:325-665-3860
Practice Address - Fax:325-793-3579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX651190000225100000X
TX550580000225X00000X
TX332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161670802Medicaid
TX161670802Medicaid