# SERC REHABILITATION PARTNERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SERC - Raytown
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982018412
- **Authorized official:** KILEY RUSSELL (MGR OF PROVIDER AND PAYER ENROLLMEN)
- **Authorized official phone:** (423) 238-8923

## Contact information

- **Practice address:** 4277 STERLING AVE, RAYTOWN, MO 64133-1351
- **Practice address phone:** (816) 353-0060
- **Practice address fax:** (816) 358-5830
- **Mailing address:** 8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
- **Mailing address phone:** (816) 226-4011
- **Mailing address fax:** (816) 524-6115

## Taxonomy

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

## Other

- **Enumeration date:** 06/12/2014
- **Last updated:** 06/12/2014