Healthcare Provider Details

I. General information

NPI: 1891091450
Provider Name (Legal Business Name): BIR JV LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 BRYANT IRVIN RD N
FORT WORTH TX
76107-7673
US

IV. Provider business mailing address

4714 GETTYSBURG RD LEGAL DEPARTMENT
MECHANICSBURG PA
17055-4325
US

V. Phone/Fax

Practice location:
  • Phone: 817-738-3157
  • Fax: 817-738-9899
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: MICHAEL E. TARVIN
Title or Position: VICE PRESIDENT
Credential:
Phone: 717-975-4503