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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1114996162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT PHYSICAL THERAPY HOLDINGS INC

Provider Business Mailing Address
First Line	:	32033 BEAVER RUN DR
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21804-1773
Country	:	US
Telephone Number	:	410-860-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	32033 BEAVER RUN DR
Second Line	:
City	:	SALISBURY
State	:	MD
Zip	:	21804-1773
Country	:	US
Telephone Number	:	410-860-6600
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MICHAEL TARVIN
Credential	:
Telephone Number	:	717-975-4503

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	02/28/2008

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