Healthcare Provider Details

I. General information

NPI: 1437898228
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 S PERRY ST STE D
CASTLE ROCK CO
80104-1942
US

IV. Provider business mailing address

4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 303-814-2865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100