Organization
PHYSICAL THERAPY & REHABILITATION CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN ANN MELLOWAY (OFFICE MANAGER)
(816) 232-2878
Entity
Organization
Contact information
Practice address
1343 VILLAGE DRIVE, ST JOSEPH, MO 64506
(816) 232-2878
(816) 232-5056
Mailing address
1343 VILLAGE DRIVE, ST JOSEPH, MO 64506
(816) 232-2878
(816) 232-5056
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06213018
BLUE CROSS BLUE SHIELD
—
Enumeration date
09/25/2006
Last updated
08/22/2020
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