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NPI Code Detail

MEDICARE: PROACTIVE THERAPY OF GREENVILLE INC

MEDICARE: PROACTIVE THERAPY OF GREENVILLE 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
1261QP2000XPhysical Therapy Clinic/CenterTN

General Provider Information

NPI Number : 1831199967
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROACTIVE THERAPY OF GREENVILLE INC
Provider Business Mailing Address
First Line : 4716 OLD GETTYSBURG RD
Second Line : LEGAL DEPARTMENT
City : MECHANICSBURG
State : PA
Zip : 17055-4325
Country : US
Telephone Number : 717-975-4503
Fax Number : 717-975-9981
Provider Business Practice Location Address
First Line : 7464 WINCHESTER RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38125-2205
Country : US
Telephone Number : 901-345-6700
Fax Number : 901-756-0098
Authorized Official
Title or Position : VICE PRESIDENT
Name : MR. MICHAEL E. TARVIN
Credential :
Telephone Number : 717-975-4503
Provider Enumeration Date : 07/29/2005
Last Update Date : 03/12/2008

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Directions to “PROACTIVE THERAPY OF GREENVILLE INC ” Practice Location

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