Healthcare Provider Details

I. General information

NPI: 1740823913
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 S SALISBURY BLVD STE 5
SALISBURY MD
21801-6845
US

IV. Provider business mailing address

4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 410-901-1100
  • Fax:
Mailing address:
  • Phone: 717-975-4556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

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