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General NPI Number Information
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NPI Number | 1962463661
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Entity Type | Organization
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Legal Business Name | SELECT PHYSICAL THERAPY OF LORAIN LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1909 N RIDGE RD E UNIT 3
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City | LORAIN
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State | OH
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Zip | 44055-3379
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Country | US
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Telephone | 440-277-9101
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Fax |
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Provider Business Mailing Address
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Address Line | 1909 N RIDGE RD E UNIT 3
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City | LORAIN
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State | OH
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Zip | 44055-3379
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Country | US
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Telephone | 440-277-9101
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MICHAEL 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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