Organization
SERC OF LIBERTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD E HELMER PT (CLINIC DIRECTOR)
(816) 792-0775
Entity
Organization
Contact information
Practice address
1512 NE 96TH ST, SUITE A, LIBERTY, MO 64068-1348
(816) 792-0775
(816) 792-0776
Mailing address
1512 NE 96TH ST, SUITE A, LIBERTY, MO 64068-1348
(816) 792-0775
(816) 792-0776
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
112594
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31732022
BCBS
MO
Enumeration date
05/08/2006
Last updated
11/02/2012
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