MEDICARE: PHYSIOTHERAPY ASSOCIATES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center		NE

General Provider Information

NPI Number	:	1013261924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC.

Provider Business Mailing Address
First Line	:	4714 GETTYSBURG RD
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17055-4325
Country	:	US
Telephone Number	:	717-972-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	12100 W CENTER RD STE 525
Second Line	:	BEL AIR PLAZA
City	:	OMAHA
State	:	NE
Zip	:	68144-3960
Country	:	US
Telephone Number	:	402-330-2774
Fax Number	:	402-330-2775

Authorized Official
Title or Position	:	CHIEF COMPLIANCE OFFICER
Name	:	MICHAEL E. TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	11/09/2018

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