# CENTRAL PHYSICAL REHABILITATION AND SPORTS MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851425912
- **Authorized official:** SHAWN ROACH (OWNER)
- **Authorized official phone:** (660) 429-4700

## Contact information

- **Practice address:** 407 E RUSSELL AVE BLDG A, SUITE 6, WARRENSBURG, MO 64093-1242
- **Practice address phone:** (660) 429-4700
- **Practice address fax:** (660) 429-0500
- **Mailing address:** 407 E RUSSELL AVE BLDG A, SUITE 6, WARRENSBURG, MO 64093-1242
- **Mailing address phone:** (660) 429-4700
- **Mailing address fax:** (660) 429-0500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/14/2007
- **Last updated:** 09/09/2011