MEDICARE: SELECT PHYSICAL THERAPY HOLDINGS 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1033395405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT PHYSICAL THERAPY HOLDINGS INC

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

Provider Business Practice Location Address
First Line	:	301 N LAKE AVE
Second Line	:	SUITE 201
City	:	PASADENA
State	:	CA
Zip	:	91101-4107
Country	:	US
Telephone Number	:	626-568-9115
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MICHAEL TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	03/15/2018

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