Healthcare Provider Details
I. General information
NPI: 1306207345
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2016
Last Update Date: 03/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8380 COLESVILLE RD SUITE 200
SILVER SPRING MD
20910-6255
US
IV. Provider business mailing address
4714 GETTYSBURG RD
MECHANICSBURG PA
17055-4325
US
V. Phone/Fax
- Phone: 301-563-3081
- Fax: 301-563-6039
- Phone: 717-972-1100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
E
TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100