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NPI Code Detail

MEDICARE: SERC REHABILITATION PARTNERS, LLC

MEDICARE: SERC REHABILITATION PARTNERS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM1300XMulti-Specialty Clinic/Center
2261QX0100XOccupational Medicine Clinic/Center
3261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1811251358
Entity Type Code : Organization
Provider Name (Legal Business Name) : SERC REHABILITATION PARTNERS, LLC
Provider Business Mailing Address
First Line : 17134 BEL RAY PL
Second Line :
City : BELTON
State : MO
Zip : 64012-5331
Country : US
Telephone Number : 816-524-5130
Fax Number : 816-524-6115
Provider Business Practice Location Address
First Line : 10801 E STATE ROUTE 350
Second Line :
City : RAYTOWN
State : MO
Zip : 64138-2367
Country : US
Telephone Number : 816-737-5500
Fax Number : 816-737-5504
Authorized Official
Title or Position : MANAGER
Name : KILEY RUSSELL
Credential :
Telephone Number : 423-238-8923
Provider Enumeration Date : 06/29/2012
Last Update Date : 09/04/2013

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Directions to “SERC REHABILITATION PARTNERS, LLC ” Practice Location

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