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Organization

SERC OF CLINTON INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEVIN L MCWILLIAMS PT (PRESIDENT/CLINICAL DIRECTOR)
(816) 524-5287
Entity
Organization

Contact information

Practice address
109 W FRANKLIN ST, CLINTON, MO 64735-2007
(816) 524-5287
(816) 434-6632
Mailing address
109 W FRANKLIN ST, CLINTON, MO 64735-2007
(816) 524-5287
(816) 434-6632

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
105255
MO
225XH1200X
Hand Occupational Therapist
003718
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
44281011
BCBS KC
MO
Enumeration date
05/26/2010
Last updated
11/01/2012
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