Organization
COVENANT REHAB CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN BARTON (OFFICE MANAGER)
(660) 646-0022
Entity
Organization
Contact information
Practice address
740 S WASHINGTON ST, CHILLICOTHE, MO 64601-3042
(660) 646-0022
(660) 646-1553
Mailing address
740 S WASHINGTON ST, CHILLICOTHE, MO 64601-3042
(660) 646-0022
(660) 646-1553
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
R1183 & 00943
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34276019
BLUE CROSS BLUE SHIELD
MO
01
—
DC2515
RAIL ROAD MEDICARE
MO
Enumeration date
06/14/2006
Last updated
03/25/2013
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