Organization
SERC REHABILITATION PARTNERS LLC
Active
Other names
SERC - Eudora, KS
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS)
(423) 238-7217
Entity
Organization
Contact information
Practice address
218 E 20TH ST, STE A, EUDORA, KS 66025-9769
(785) 542-3333
(785) 542-3330
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
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
04/26/2016
Last updated
12/07/2016
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