Healthcare Provider Details

I. General information

NPI: 1669432464
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date: 12/03/2007
Reactivation Date: 01/11/2008

III. Provider practice location address

12 STILLWATER AVE
BANGOR ME
04401
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DPT
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 207-945-2946
  • Fax: 207-945-0207
Mailing address:
  • Phone: 717-972-1100
  • Fax: 717-975-9731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateME

VIII. Authorized Official

Name: JOHN F DUGGAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-972-1100