Healthcare Provider Details
I. General information
NPI: 1932178860
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2006
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2763 OFFICE PARK CIR
MONTGOMERY AL
36116-1143
US
IV. Provider business mailing address
4714 GETTYSBURG RD LEGAL DEPT
MECHANICSBURG PA
17055-4325
US
V. Phone/Fax
- Phone: 334-284-8490
- Fax:
- Phone: 717-972-1100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100