Organization
MID AMERICA REHAB, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WAYNE SHERRILL PT,CHT (OWNER)
(573) 339-5989
Entity
Organization
Contact information
Practice address
3047 WILLIAM ST, CAPE GIRARDEAU, MO 63703-6393
(573) 339-5989
(573) 339-7092
Mailing address
3047 WILLIAM ST STE 100, CAPE GIRARDEAU, MO 63703-6569
(573) 339-5989
(573) 339-7092
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251H1200X
Hand Physical Therapist
—
—
2255A2300X
Athletic Trainer
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31376
BLUE CROSS
MO
01
—
326581
HEALTHLINK
MO
05
—
578069601
—
MO
Enumeration date
02/17/2006
Last updated
12/09/2022
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