MEDICARE: SELECT PHYSICAL THERAPY OF OHIO LIMITED PARTNERSHIP

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	:	1902867641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT PHYSICAL THERAPY OF OHIO LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	STE 103
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-435-4004
Fax Number	:

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	STE 103
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-435-4004
Fax Number	:

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

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	02/28/2008

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