Healthcare Provider Details

I. General information

NPI: 1497791883
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 03/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13537 BARRETT PARKWAY DR STE 200
MANCHESTER MO
63021-5899
US

IV. Provider business mailing address

13537 BARRETT PARKWAY DR STE 200
MANCHESTER MO
63021-5899
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-2273
  • Fax:
Mailing address:
  • Phone: 314-966-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-975-4503