MEDICARE: SELECT PHYSICAL THERAY 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	:	1144281312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT PHYSICAL THERAY HOLDINGS INC

Provider Business Mailing Address
First Line	:	190 HIGHWAY 18
Second Line	:	STE 203
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1407
Country	:	US
Telephone Number	:	732-846-0222
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 HIGHWAY 18
Second Line	:	STE 203
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-1407
Country	:	US
Telephone Number	:	732-846-0222
Fax Number	:

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	03/21/2008

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