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NPI Code Detail

MEDICARE: PROACTIVE THERAPY OF VIRGINIA INC

MEDICARE: PROACTIVE THERAPY OF VIRGINIA 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
1261QP2000XPhysical Therapy Clinic/CenterVA

General Provider Information

NPI Number : 1548260193
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROACTIVE THERAPY OF VIRGINIA 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 : 711-975-9981
Provider Business Practice Location Address
First Line : 2726 ELECTRIC RD
Second Line : SUITE 101
City : ROANOKE
State : VA
Zip : 24018-3528
Country : US
Telephone Number : 540-989-8974
Fax Number : 540-989-4695
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 : 06/05/2012

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Directions to “PROACTIVE THERAPY OF VIRGINIA INC ” Practice Location

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