| NPI | 1982018412 |
|---|---|
| Doing Business As | SERC - RAYTOWN |
| Entity Type | Organization |
| Authorized Contact | KILEY RUSSELL Mgr Of Provider And Payer Enrollmen 423-238-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |