Organization
SERC OF LEE'S SUMMIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A WERNSMAN MPT (CLINIC DIRECTOR)
(816) 537-5650
Entity
Organization
Contact information
Practice address
3747 SW RAINTREE DR, LEES SUMMIT, MO 64082-4606
(816) 537-5650
(816) 537-5649
Mailing address
3747 SW RAINTREE DR, LEES SUMMIT, MO 64082-4606
(816) 537-5650
(816) 537-5649
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2001014048
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35689021
BCBS
MO
Enumeration date
05/05/2006
Last updated
11/01/2012
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