# SERC REHABILITATION PARTNERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SERC - Sedalia, MO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013469105
- **Authorized official:** KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS)
- **Authorized official phone:** (423) 238-7217

## Contact information

- **Practice address:** 115 W BROADWAY BLVD, STE 300, SEDALIA, MO 65301-5708
- **Practice address phone:** (660) 827-2945
- **Practice address fax:** (660) 827-2961
- **Mailing address:** 8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
- **Mailing address phone:** (423) 238-7217
- **Mailing address fax:** (423) 238-3473

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | MO | — |
| 261QP2000X | Physical Therapy Clinic/Center | — | MO | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | — | MO | — |

## Other

- **Enumeration date:** 10/25/2016
- **Last updated:** 10/25/2016