Provider Demographics
NPI:1437332905
Name:SERC HAND NORTH INC
Entity Type:Organization
Organization Name:SERC HAND NORTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, CHT
Authorized Official - Phone:816-420-0286
Mailing Address - Street 1:7932 N OAK TRFY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-1423
Mailing Address - Country:US
Mailing Address - Phone:816-420-0286
Mailing Address - Fax:816-420-8207
Practice Address - Street 1:7932 N OAK TRFY
Practice Address - Street 2:SUITE 212
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-1423
Practice Address - Country:US
Practice Address - Phone:816-420-0286
Practice Address - Fax:816-420-8207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004600225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO39684012OtherBCBS
MOMA1009Medicare UPIN