Organization
SERC OF KEARNEY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI L JACKSON PT (CLINIC DIRECTOR)
(816) 903-0775
Entity
Organization
Contact information
Practice address
101 W 92 HWY, SUITE H, KEARNEY, MO 64060-7590
(816) 903-0775
(816) 903-0776
Mailing address
101 W 92 HWY, SUITE H, KEARNEY, MO 64060-7590
(816) 903-0775
(816) 903-0776
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2002030223
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37002019
BCBS
MO
Enumeration date
05/08/2006
Last updated
02/14/2013
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