Provider Demographics
NPI:1700800364
Name:ADVANCE MEDICAL SERVICES WELLNESS CENTER
Entity Type:Organization
Organization Name:ADVANCE MEDICAL SERVICES WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILTON-KYER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:314-535-4040
Mailing Address - Street 1:2601 WHITTIER ST
Mailing Address - Street 2:THE WELLNESS CENTER
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63113-2957
Mailing Address - Country:US
Mailing Address - Phone:314-535-4040
Mailing Address - Fax:314-535-4041
Practice Address - Street 1:2601 WHITTIER ST
Practice Address - Street 2:THE WELLNESS CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63113-2957
Practice Address - Country:US
Practice Address - Phone:314-535-4040
Practice Address - Fax:314-535-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
Not Answered2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty