MEDICARE: SPORTS AND ORTHOPEDIC REHABILITATION SERVICES 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	:	1720132616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPORTS AND ORTHOPEDIC REHABILITATION SERVICES 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	:

Provider Business Practice Location Address
First Line	:	4655 66TH ST N
Second Line	:	NUMBER 22B
City	:	KENNETH CITY
State	:	FL
Zip	:	33709-4827
Country	:	US
Telephone Number	:	727-546-4700
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	JOHN F DUGGAN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	10/14/2025

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