Organization
SERC OF ODESSA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID S DOWDY DPT (CLINIC DIRECTOR/AREA DIRECTOR)
(816) 633-4063
Entity
Organization
Contact information
Practice address
211 N 2ND ST, ODESSA, MO 64076-1135
(816) 633-4063
(816) 633-4264
Mailing address
211 N 2ND ST, ODESSA, MO 64076-1135
(816) 633-4063
(816) 633-4264
Taxonomy
Speciality
Code
Description
License number
State
2251H1200X
Hand Physical Therapist
Primary
2002006834
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34362045
BCBS
MO
Enumeration date
10/19/2009
Last updated
11/02/2012
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