MEDICARE: THERAWORKS 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

General Provider Information

NPI Number	:	1457595175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAWORKS INC

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:	LEGAL DEPT
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-975-4503
Fax Number	:

Provider Business Practice Location Address
First Line	:	5514 ATASCOCITA RD
Second Line	:	STE 160
City	:	HUMBLE
State	:	TX
Zip	:	77346-2968
Country	:	US
Telephone Number	:	281-441-5371
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MICHAEL E. TARVIN
Credential	:
Telephone Number	:	717-975-4503

Provider Enumeration Date	:	04/24/2009
Last Update Date	:	09/04/2009

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Directions to “THERAWORKS INC ” Practice Location

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