| Organization Name: | WORKERS' COMPENSATION MEDICAL CONSULTING, LC |
| NPI Number: | 1235395724 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY ANN HOLLMAN (PRESIDENT) |
| Mailing Address: | 2638 Highway 109 Suite 101 Wildwood |
| State: | MO US |
| Postal Code: | 630401161 |
| Phone Number: | 6367303177 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 08/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | R9N85 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |