Individual
MICHAEL A FALLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3148 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63139-1118
(314) 664-4448
(314) 664-4415
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000305
MO
Other
Enumeration date
05/22/2018
Last updated
05/22/2018
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