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General NPI Number Information
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NPI Number | 1710119235
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Entity Type | Organization
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Legal Business Name | SELECT MEDICAL
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 17 OSPREY LN
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-1893
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Country | US
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Telephone | 610-458-9336
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Fax |
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Provider Business Mailing Address
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Address Line | 17 OSPREY LN
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City | DOWNINGTOWN
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State | PA
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Zip | 19335-1893
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Country | US
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Telephone |
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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 | TAMI SANDERS
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Credential |
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Telephone | 610-458-9336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number | TE1000596
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License Number State | PA
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