| NPI | 1033755871 |
|---|---|
| Other Name | SERC - WICHITA NORTHWEST, KS |
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHANNESON VP Revenue Cycle Operations 423-238-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |