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NPI Profile for SERC OF ODESSA INC in ODESSA, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hand |
2251H1200X | 65 | Physical Therapist in Private Practice |
| NPI # | 1699001164 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/19/2009 | |
| Last updated | 11/02/2012 - About 14 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SERC OF ODESSA INC
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SERC OF ODESSA INC