Organization
SERC OF LANSING
Active
Organization
SERC OF LANSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON S LANGFORD MPT, ATC (CLINIC MANAGER)
(913) 351-3838
Entity
Organization
Contact information
Practice address
1004 PROGRESS DR, SUITE 100, LANSING, KS 66043-6326
(913) 351-3838
(913) 351-3939
Mailing address
1004 PROGRESS DR, SUITE 100, LANSING, KS 66043-6326
(913) 351-3838
(913) 351-3939
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03375
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39845014
BCBS
KS
Enumeration date
01/03/2008
Last updated
11/01/2012
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