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Organization
SERC REHABILITATION PARTNERS LLC
Active
Organization
SERC REHABILITATION PARTNERS LLC
Active
Other names
SERC - Sedalia, MO
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS)
(423) 238-7217
Entity
Organization
Contact information
Practice address
115 W BROADWAY BLVD, STE 300, SEDALIA, MO 65301-5708
(660) 827-2945
(660) 827-2961
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
MO
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MO
261QX0100X
Occupational Medicine Clinic/Center
—
MO
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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