Healthcare Provider Details

I. General information

NPI: 1063774586
Provider Name (Legal Business Name): SELECT PHYSICAL THERAPY HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 N BROADWAY AVE # 416
SHAWNEE OK
74801-6922
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DEPT
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 405-273-1523
  • Fax: 405-273-1743
Mailing address:
  • Phone: 717-972-1100
  • Fax: 717-975-9981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN F DUGGAN
Title or Position: CHIEF LEGAL OFFICER
Credential:
Phone: 717-972-1100