Provider Demographics
NPI:1295940500
Name:WORK&REHAB LLC
Entity type:Organization
Organization Name:WORK&REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
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:OT
Authorized Official - Phone:325-795-9675
Mailing Address - Street 1:4546 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4737
Mailing Address - Country:US
Mailing Address - Phone:325-795-9675
Mailing Address - Fax:
Practice Address - Street 1:4546 S 14TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4737
Practice Address - Country:US
Practice Address - Phone:325-795-9675
Practice Address - Fax:325-795-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX550580000332BC3200X
TX550580000,651190000335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161670802Medicaid
TX161670802Medicaid
TX4846190001Medicare PIN