MEDICARE: REHABCLINICS GALAXY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center		WI

General Provider Information

NPI Number	:	1447250006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABCLINICS GALAXY INC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPARTMENT
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:	717-975-9981

Provider Business Practice Location Address
First Line	:	4600 W LOOMIS RD
Second Line	:	SUITE 120
City	:	GREENFIELD
State	:	WI
Zip	:	53220-4858
Country	:	US
Telephone Number	:	414-281-7247
Fax Number	:	414-281-7325

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. MICHAEL E. TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	03/02/2011

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Practice Location Address:

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