Organization
SERC REHABILITATION PARTNERS LLC
Active
Other names
SERC - Waldo, MO
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE OPERATIONS)
(423) 238-7217
Entity
Organization
Contact information
Practice address
2 E GREGORY BLVD, STE 200, KANSAS CITY, MO 64114-1118
(816) 926-0222
(816) 926-0277
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
MO
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MO
261QX0100X
Occupational Medicine Clinic/Center
—
MO
Other
Enumeration date
02/20/2017
Last updated
02/21/2017
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