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General NPI Number Information
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NPI Number | 1235723677
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Entity Type | Organization
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Legal Business Name | SELECT REHABILITATION
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Dates
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Enumeration Date | 02/25/2021
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 200 OHIO ST
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City | MEDINA
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State | NY
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Zip | 14103-1063
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Country | US
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Telephone | 585-798-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5334 GENESEE ST APT 1
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City | BOWMANSVILLE
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State | NY
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Zip | 14026-1062
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Country | US
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Telephone | 716-474-6087
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | JOSHUA ROBERT HOTZ
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Credential |
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Telephone | 716-474-6087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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