NPI | 1215355243 |
---|---|
Doing Business As | SERC - SAINT JOSEPH |
Entity Type | Organization |
Authorized Contact | KILEY RUSSELL Mgr Of Provider/Payer Enrollment 423-238-8923 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
Enumeration Date | 2014-04-07 |
Last Update Date | 2014-04-07 |