MEDICARE: KEYSTONE REHABILITATION SYSTEMS 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
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1134412455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEYSTONE REHABILITATION SYSTEMS INC

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

Provider Business Practice Location Address
First Line	:	306 W MAIN ST
Second Line	:
City	:	SAINT CLAIRSVILLE
State	:	OH
Zip	:	43950-8801
Country	:	US
Telephone Number	:	740-695-0832
Fax Number	:	740-695-0843

Authorized Official
Title or Position	:	VICE PRESIDENT & SECRETARY
Name	:	MR. MICHAEL E TARVIN
Credential	:
Telephone Number	:	717-972-1100

Provider Enumeration Date	:	05/19/2011
Last Update Date	:	11/15/2018

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