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General NPI Number Information
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NPI Number | 1356301196
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Entity Type | Organization
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Legal Business Name | SELECT PHYSICAL THERAPY OF MICHIGAN, INC.
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 3921 JACKSON RD
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City | ANN ARBOR
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State | MI
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Zip | 48103
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Country | US
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Telephone | 734-665-1626
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Fax | 734-665-2414
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Provider Business Mailing Address
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Address Line | 4714 GETTYSBURG RD LEGAL DEPARTMENT
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4325
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Country | US
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Telephone | 717-975-4503
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Fax | 717-975-9981
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHAEL E TARVIN
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Credential |
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Telephone | 717-975-4503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | MI
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